Ovary tumor
Other ovarian specific tumors
Small cell carcinoma of ovary, hypercalcemic type

Authors: Nat Pernick, M.D. (see Authors page)

Revised: 17 June 2016, last major update December 2008

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: small cell carcinoma hypercalcemic type
Definition / General
  • Mean age 23, range 9-43 years, associated with hypercalcemia in 2/3 which disappears after excision
  • More common than pulmonary type
  • Poor prognosis due to extra-ovarian spread (50% in stage IA die of disease); better prognosis if 30 years or older, normal preoperative serum calcium, < 10 cm size and no large cells (Am J Surg Pathol 1994;18:1102)
  • Often associated with surface epithelial tumor
  • Not associated with hyperestrogenic effects
  • May be of germ cell origin (Hum Pathol 1987;18:175)
Case Reports
Gross Description
  • Mean 15 cm (range 6-26 cm), solid, fleshy mass with hemorrhage and necrosis
Gross Images

Images hosted on PathOut server:

Fleshy cream-colored tissue

Micro Description
  • Diffuse sheets of small, closely packed round cells with scant cytoplasm, small hyperchromatic nuclei with irregular chromatin clumps, small but identifiable nucleoli
  • Cytoplasmic hyaline globules, follicle-like structures with eosinophilic fluid, frequent mitotic figures; tumor necrosis with perivascular sparing
  • 50% have large cells with abundant eosinophilic cytoplasm and large nuclei with prominent nucleoli; 10% have mucinous epithelial cells with intracytoplasmic mucin; no crush artifact or Azzopardi effect
Micro Images

Images hosted on PathOut server:

Diffuse growth of small cells with scanty cytoplasm

Hyperchromatic nuclei

Growing in nests

Follicle-like structures with eosinophilic material

Large cell variant

Several mucinous glands

Signet-ring cells in basophilic mucin

Several glands lined by tumor cells, some with mucin



Images hosted on other servers:

Various images


Fig 1: solid areas are soft, pale-tan to gray; fig 2/3: sheets of small-medium cells with scant cytoplasm,
round/oval hyperchromatic nuclei, frequent mitotic figures, ectatic vessels; fig 4: vimentin+


Fig 1: tan, friable, fleshy mass with softening and hemorrhage; 2/3: diffuse sheets of small, closely packed cells with scant cytoplasm and frequent mitotic figures; 4: large areas of tumor necrosis with pseudopapillary architecture

Cytology Description
  • Highly cellular with poorly cohesive uniform small cells with scant cytoplasm, round / oval hyperchromatic nuclei, inconspicuous nucleoli and occasional mitotic figures
Positive Stains
  • CAM 5.2, vimentin (50%), variable chromogranin, laminin, PTH-related protein and EMA (30%)
Negative Stains
Electron Microscopy Description
Molecular / Cytogenetics Description
  • Diploid
Differential Diagnosis