Cargando…

Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report

RATIONALE: Ovarian small cell carcinoma of hypercalcemic type (OSCCHT) is a relatively rare and highly fatal gynecological malignancy of unknown histogenesis, affecting mainly girls and young women. OSCCHT occurring during pregnancy is an uncommon event, and preoperative diagnosis of this malignancy...

Descripción completa

Detalles Bibliográficos
Autores principales: Feng, Min, Yang, Kaixuan, Xu, Lian, Zhang, Yan, Zou, Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387015/
https://www.ncbi.nlm.nih.gov/pubmed/32791659
http://dx.doi.org/10.1097/MD.0000000000020387
_version_ 1783564057056378880
author Feng, Min
Yang, Kaixuan
Xu, Lian
Zhang, Yan
Zou, Juan
author_facet Feng, Min
Yang, Kaixuan
Xu, Lian
Zhang, Yan
Zou, Juan
author_sort Feng, Min
collection PubMed
description RATIONALE: Ovarian small cell carcinoma of hypercalcemic type (OSCCHT) is a relatively rare and highly fatal gynecological malignancy of unknown histogenesis, affecting mainly girls and young women. OSCCHT occurring during pregnancy is an uncommon event, and preoperative diagnosis of this malignancy is much more difficult in pregnant than non-pregnant women. The aim of this study was to describe a rare case of primary OSCCHT in a pregnant woman and to review the current literature. PATIENT CONCERNS: Here we present a case of OSCCHT in a 21-year-old patient in the 32nd week of gestation, who had abdominal pain and irregular vaginal bleeding for 5 hours. Because placental abruption, stillbirth, and hemorrhagic shock were suspected, she subsequently underwent diagnostic laparotomy. During the hysterotomy delivery and exploratory laparotomy, we found a dead fetus in the uterus and a large tumor mass arising from her left ovary. Plasma-based detection showed that the patient had a slightly elevated parathyroid hormone (PTH) level and normal serum calcium. After surgery, her serum PTH levels returned to normal. DIAGNOSIS AND INTERVENTIONS: The patient was initially treated with surgery. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as the following additional procedures: appendectomy, sigmoidectomy, debulking of extra-ovarian tumor, lymph node dissection, and peritoneal biopsies. The patient, who was in the third trimester of pregnancy, was diagnosed with OSCCHT that was confirmed to be Stage III. She was recommended chemotherapy after surgery, but she declined chemotherapy. OUTCOMES: Unfortunately, the patient died 5 months after surgery. LESSONS: OSCCHT is a very rare and highly aggressive tumor type. The clinical symptoms of this tumor are nonspecific, and pathological examination remains the gold standard for diagnosis. Most patients are diagnosed with advanced stage disease and do not respond to chemotherapy. The prognosis of OSCCHT is generally poor, and no treatment guidelines are available as yet. For pregnant woman, OSCCHT is especially harmful to the mother and may indirectly lead to the death of the fetus.
format Online
Article
Text
id pubmed-7387015
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-73870152020-08-05 Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report Feng, Min Yang, Kaixuan Xu, Lian Zhang, Yan Zou, Juan Medicine (Baltimore) 5600 RATIONALE: Ovarian small cell carcinoma of hypercalcemic type (OSCCHT) is a relatively rare and highly fatal gynecological malignancy of unknown histogenesis, affecting mainly girls and young women. OSCCHT occurring during pregnancy is an uncommon event, and preoperative diagnosis of this malignancy is much more difficult in pregnant than non-pregnant women. The aim of this study was to describe a rare case of primary OSCCHT in a pregnant woman and to review the current literature. PATIENT CONCERNS: Here we present a case of OSCCHT in a 21-year-old patient in the 32nd week of gestation, who had abdominal pain and irregular vaginal bleeding for 5 hours. Because placental abruption, stillbirth, and hemorrhagic shock were suspected, she subsequently underwent diagnostic laparotomy. During the hysterotomy delivery and exploratory laparotomy, we found a dead fetus in the uterus and a large tumor mass arising from her left ovary. Plasma-based detection showed that the patient had a slightly elevated parathyroid hormone (PTH) level and normal serum calcium. After surgery, her serum PTH levels returned to normal. DIAGNOSIS AND INTERVENTIONS: The patient was initially treated with surgery. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as the following additional procedures: appendectomy, sigmoidectomy, debulking of extra-ovarian tumor, lymph node dissection, and peritoneal biopsies. The patient, who was in the third trimester of pregnancy, was diagnosed with OSCCHT that was confirmed to be Stage III. She was recommended chemotherapy after surgery, but she declined chemotherapy. OUTCOMES: Unfortunately, the patient died 5 months after surgery. LESSONS: OSCCHT is a very rare and highly aggressive tumor type. The clinical symptoms of this tumor are nonspecific, and pathological examination remains the gold standard for diagnosis. Most patients are diagnosed with advanced stage disease and do not respond to chemotherapy. The prognosis of OSCCHT is generally poor, and no treatment guidelines are available as yet. For pregnant woman, OSCCHT is especially harmful to the mother and may indirectly lead to the death of the fetus. Wolters Kluwer Health 2020-07-24 /pmc/articles/PMC7387015/ /pubmed/32791659 http://dx.doi.org/10.1097/MD.0000000000020387 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5600
Feng, Min
Yang, Kaixuan
Xu, Lian
Zhang, Yan
Zou, Juan
Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title_full Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title_fullStr Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title_full_unstemmed Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title_short Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: A case report
title_sort primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman: a case report
topic 5600
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387015/
https://www.ncbi.nlm.nih.gov/pubmed/32791659
http://dx.doi.org/10.1097/MD.0000000000020387
work_keys_str_mv AT fengmin primaryovariansmallcellcarcinomaofhypercalcemictypeinapregnantwomanacasereport
AT yangkaixuan primaryovariansmallcellcarcinomaofhypercalcemictypeinapregnantwomanacasereport
AT xulian primaryovariansmallcellcarcinomaofhypercalcemictypeinapregnantwomanacasereport
AT zhangyan primaryovariansmallcellcarcinomaofhypercalcemictypeinapregnantwomanacasereport
AT zoujuan primaryovariansmallcellcarcinomaofhypercalcemictypeinapregnantwomanacasereport