MR imaging diagnosis of small-cell carcinoma of the ovary, hypercalcemic type: A case report and literature review

Abstract

Rationale: Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a rare and aggressive gynecological tumor. We retrospectively analyzed the clinical manifestations and imaging findings of this patient and analyzed the relevant literature, with the aim of improving the ability of radiologists to differentiate SCCOHT from other ovarian tumors.

Patient concerns: We report a case of 36-year-old woman who was diagnosed with SCCOHT. MRI suggested a malignant tumor of the left ovary. The immunohistochemical markers shows SMARCA4 negativity. Notably, hypercalcemia was not detected. Microscopically, it was consistent with the large-cell variants.

Lessions: Despite its rarity, SCCOHT should still be considered in the differential diagnosis of ovarian malignancies. When a young female patient presents with a large unilateral tumor on MRI with a predominant solid component and significant enhancement on the contrast enhanced scans, along with hypercalcemia, SCCOHT should be considered.

Figure 1.

(A–C) A 36-year-old female patient with small cell carcinoma of the ovary, hypercalcemic type. Axial and sagittal T2-weighted MR images demonstrate a heterogeneous mass.

Figure 2.

(A and B) When b = 800s/mm², the solid component showed a slightly hyperintense signal on DWI images. (C and D) ADC images showed a hypointense signal.

Figure 3.

(A and B) The septa and edges of the lesions were enhanced and the solid part was significantly enhanced.

Figure 4.

The tumor cells were infiltrative and varied in size, a glassy eosinophilic cytoplasm and eccentric large pale nuclei are to be seen, indicating the presence of large-cell variants.