Small cell carcinoma of the ovary successfully treated with radiotherapy only after surgery: case report

Small cell ovarian tumors are rare and highly malignant, occurring mainly in young patients. Early mortality is high due to the lack of an effective treatment. The first adjuvant therapy is usually chemotherapy. Case: During laparotomy for renal transplant in a 17-year-old girl, the right ovary exhibited a Suspicious mass, whose pathological diagnosis was Stage I A small cell ovarian tumor. Prognosis was poor (young age, hypercalcemia, tumor > 10 cm, and presence of large cells). Since chemotherapy is contraindicated for dialysed patients, only radiotherapy was given. The patient is still alive and disease-free ten years after diagnosis. Conclusion: This is the first case with a poor prognosis reported in the literature that has been successfully cured by Surgery plus adjuvant radiotherapy only.

[1] Scully R.E.: “Small cell carcinoma of hypercalcemic type”. Int. J. Gynecol. Path., 1993, 12, 148.

[2] Dickersin G.R., Kline I.W., Scully R.E.: “Small cell carcinoma of the ovary with hypercalcemia: a report of eleven cases”. Cancer, 1982, 49, 188.

[3] Distelmaier F., Calaminus G., Harms D., Sträter R., Kordes U., Fleischhack G. et al.: “Ovarian small cell carcinoma of the hypercalcemic type in children and adolescents”. Cancer, 2006, 107, 2298.

[4] Young R.H., Kline I.W., Scully R.E.: “Small cell carcinoma of the ovary, hypercalcemic type. A clinicopathological analysis of 150 cases”. Am. J. Surg. Pathol., 1994, 18, 1102.

[5] Harrison M.L., Hoskins P., du Bois A., Quinn M., Rustin G.J.S., Ledermann J.A. et al.: “Small cell of the ovary, hypercalcemic type-analysis of combined experience and recommendation for management. A GCIG study”. Gynecol. Oncol., 2006, 100, 233.

[6] Aguirre P., Thor A.D., Scully R.E.: “Ovarian small cell carcinoma. Histogenetic considerations based on immunohistochemical and other findings”. Am. J. Clin. Pathol., 1989, 92, 140.

[7] Walt H., Hornung R., Fink D., Dobler-Girdziunaite D., Stallmach T., Spycher M.A. et al.: “Hypercalcemic-type of smal cell carcinoma of the ovary: characterization of a new tumor line”. Anticancer Res., 2001, 21, 3253.

[8] Eichhorm J.H., Bell D.A., Young R.H., Swymer C.M., Flotte T.J., Preffer R.I., Scully R.E.: “DNA content and proliferative activity in ovarian small cell carcinomas of hypercalcemic type. Implications for diagnosis, prognosis, and histogenesis”. Am. J. Clin. Pathol., 1992, 98, 579.

[9] Benrubi G.I., Pitel P., Lammert N.: “Small cell carcinoma of the ovary with hypercalcemia responsive to sequencing chemotherapy”. South Med. J., 1993, 86, 247.

[10] Firat S., Murray K., Erickson B.: “High-dose whole abdominal and pelvic irradiation for treatment of ovarian carcinoma: longterm toxicity and outcomes”. Int. J. Radiat. Oncol. Biol. Phys., 2003, 57, 201.