© The Author (2008). Published by Oxford University Press. All rights reserved
A Case of Ovarian Cancer Associated with Hypercalcemia
Gynecology Division
National Cancer Center Hospital
Tokyo, Japan
A 56-year-old female was referred to our hospital for the further evaluation and treatment of a huge pelvic tumor. She complained of lower abdominal pain, malaise and constipation. Extensive imaging study using CT and MRI demonstrated bilateral ovarian tumors (left, 16 cm; right, 10 cm in maximum diameter) with a small amount of ascites, but no distant metastasis. Pelvic MRI depicted papillary protrusions inside the tumor and also irregular thickening of the ovarian wall, suggesting a complex of cystic and solid components (Fig. 1). On blood chemistry, serum CA-125 antigen and calcium levels increased to 92 U/ml and 15.5 mg/dl, respectively. The electrocardiogram showed shortened QT intervals. Serum calcitonin level was within normal limit, and there was no abnormal finding in the thyroid or parathyroid. Our preoperative diagnosis was early-staged ovarian cancer associated with hypercalcemia. We conducted surgical resection of the ovarian tumor following correction of the serum calcium concentration.
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As a result, she underwent hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and pelvic lymphadenectomy. At laparotomy, the ovarian tumor had already ruptured, but there were no distinct metastatic or disseminated lesions. The histological examination of the resected specimens demonstrated clear cell adenocarcinoma arising from both of the ovaries. After surgery, serum calcium and CA-125 levels quickly diminished to normal ranges. She underwent six courses of adjuvant chemotherapy using paclitaxel and carboplatin. She has been alive without recurrence 13 months after the primary surgery.
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