Dysgerminoma associated with hypercalcemia: A case report

Abstract

Hypercalcemia is an extremely rare paraneoplastic manifestation of malignancy in children. The authors report a case of dysgerminoma in a 14-year-old girl associated with severe hypercalcemia that only resolved after excision of the tumor. There are only 6 previously reported cases of dysgerminoma associated with hypercalcemia. Serum calcium levels should be checked in all children with solid ovarian tumors. Hypercalcemia in such circumstances may be resistant to medical management, and surgical resection of the tumor results in the normalization of calcium levels.

Paraneoplastic Cholestasis Associated With Ovarian Dysgerminoma

“…[2][3][4] Similar paraneoplastic manifestations were noted in three patients with dysgerminomas. [6][7][8] Individual cases of paraneoplastic neurologic syndromes have also been reported in patients with teratomas [16][17][18] as well as hypercalcemia mediated by parathyroid-related protein 19 and a case of Cushing syndrome resulting from ectopic adrenocorticotropic hormone secretion caused by primary ovarian mature teratoma with carcinoid components. 20 Jaundice has only been previously reported in patients with ovarian carcinoma with metastatic disease to the hepatic hilar lymph nodes.…”

Excision of extensive metastatic dysgerminoma to control refractory hypercalcaemia in a child at high risk for tumour-lysis syndrome

“…Previous reports have described removal of isolated ovarian dysgerminomas to control malignant hypercalcaemia in children [2,3]. Rare cases of hypercalcaemia in adults with metastatic dysgerminoma have been managed in a variety ways, ranging from abdominal radiotherapy or chemotherapy to bilateral oophorectomy, with or without hysterectomy [5][6][7][8].…”

“…In children with solid tumours, malignant hypercalaemia is rarer still and may be highly resistant to medical treatment (resolving only once the tumour is excised) [2]. Dysgerminomas are classic examples where excision of isolated ovarian lesions has promptly controlled associated hypercalcaemia [2,3]. In children with huge ovarian primaries judged unsuitable for primary excision, chemotherapy and even tumour chemoembolisation have been tried instead for calcium control [4].…”

A Large Pelvic Mass in an Adolescent Patient with Granulomatous Nephritis: Case Report and Discussion of Treatment Challenges

“…Five to 20% of adults have hypercalcemia with malignancy and 0.4% of children with malignant disease have been shown to have elevated calcium. 20 The hypercalcemia in malignancy is generally thought to result from the secretion of a bioactive peptide called parathyroid-related protein from the tumor. This peptide binds to parathyroid hormone receptors in the bone and kidney, causing bone resorption and increased renal tubular resorption of calcium.…”

“…20 Distant granulomas also have rarely been reported in the literature in association with seminomas to account for the patient's renal manifestations. 21 As the growth of dysgerminomas is by similar mechanisms to seminomas, the possibility of paraneoplastic granulomatous disease associated with this tumor is plausible.…”