Ovary
Miscellaneous tumors
Small cell carcinoma of ovary, hypercalcemic type
Author: Nat Pernick, M.D.
Last author update: 1 December 2008
Last staff update: 10 April 2023 (update in progress)
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: small cell carcinoma hypercalcemic type
Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Electron microscopy description | Molecular / cytogenetics description | Differential diagnosisCite this page: Pernick N. Small cell carcinoma of ovary, hypercalcemic type. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorsmallcellhyper.html. Accessed June 5th, 2023.
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
- 26 year old woman with right ovarian mass (Arch Pathol Lab Med 2006;130:e56)
- 32 year old woman with bilateral pleural effusions and ovarian mass (Arch Pathol Lab Med 2003;127:e271)
- 37 year old woman with ectopic parathyroid hormone production (Arch Pathol Lab Med 2005;129:531)
Gross description
- Mean 15 cm (range 6-26 cm), solid, fleshy mass with hemorrhage and necrosis
Gross images
AFIP images
Fleshy cream-colored tissue
Microscopic (histologic) 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
Microscopic (histologic) images
AFIP images
Diffuse growth of small cells with scanty cytoplasm
Hyperchromatic nuclei
Growing in nests
Large cell variant
Follicle-like structures with eosinophilic material
Several mucinous glands
Signet-ring cells in basophilic mucin
Several glands lined by tumor cells, some with mucin
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
- B72.3, S100 (Am J Clin Pathol 1989;92:140) and inhibin
Electron microscopy description
- Poorly differentiated; abundant dilated rough endoplasmic reticulum; no neurosecretory granules (Am J Clin Pathol 1988;90:523)
Molecular / cytogenetics description
- Diploid
Differential diagnosis
- Dysgerminoma
- Granulosa cell tumor: different morphology, not associated with hypercalcemia
- Lymphoma (Burkitt)
- Ovarian small cell carcinoma of pulmonary type
