First described in 1982, small cell carcinoma of the ovary has been reported in females aged 7 to 43 years.6 In a review of 150 patients, 60% to 70% had preoperative hypercalcemia that was asymptomatic in all but 4 patients. One patient even underwent neck exploration with negative results before the ovarian tumor was discovered. Symptoms and signs on presentation included abdominal swelling, discomfort, menstrual irregularity, or an asymptomatic pelvic mass. The small cell carcinoma of the ovary was unilateral in 99% of patients, but half already had evidence of metastases. The tumors were large (average size, 15.3 cm), nodular, solid, tan-gray, and might have had areas of hemorrhage, necrosis, or cystic degeneration. Microscopically, tumor cells were usually small with round nuclei, scanty cytoplasm, and frequent mitoses. The cells typically grew in diffuse sheets that were frequently separated by folliclelike structures, and they often stained positive for parathyroid hormone–related protein.6,8 The conventional treatment was surgery. Many combinations of chemotherapy and radiotherapy had been attempted with variable results.6- 7 In patients with stage IA disease (confined to 1 ovary, not through the capsule), one third remained disease free for 1 to 13 years after surgery, one half died within 2 years, and the remainder had recurrences. Almost all tumors above stage IA were fatal. Factors associated with a more favorable prognosis for stage IA tumors include an age of 30 years or older, normal preoperative calcium levels, tumor size less than 10 cm, and the absence of large cells.