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Special Feature
January 2002

Pathological Case of the Month

Arch Pediatr Adolesc Med. 2002;156(1):84. doi:

Figure 1. A 15 × 12 × 12 cm (865 g) solid, tan-gray, hemorrhagic right ovarian mass with cystic degeneration removed from a 13-year-old girl with symptoms of hypercalcemia.

Figure 2. Small cell carcinoma of the ovary showing characteristic sheets of small round cells, frequent mitoses, and folliclelike structures.

Childhood hypercalcemia is usually chronic and asymptomatic. We described an adolescent girl with sudden onset of symptomatic hypercalcemia associated with ovarian small cell carcinoma.

The signs and symptoms of hypercalcemia1,2 include nausea, vomiting, polyuria, polydipsia, dehydration, anorexia, and constipation. As calcium levels continue to rise, there may be altered consciousness, weakness, paresthesias, decreased QT interval, hypertension, and even paralysis. Most of the early signs and symptoms are nonspecific. Therefore, the diagnosis is easily confused with more common pediatric problems.