Endocrine Abstracts

A 74 year old female presented with symptoms of recent fatigue, nausea and weight loss. No other symptoms were present. She had previously had a hysterectomy with conservation of both ovaries 30 years previously for fibroids. The rest of her history was unremarkable. No undue clinical findings were apparent on examination. Initial bloods revealed normal haematology, biochemistry and liver profiles. Corrected calcium was elevated at 3.07 millimoles per litre(2.1-2.6). Subsequent tests displayed a normal chest x-ray, a suppressed PTH level of 1.0 picograms per millilitre(10-70), a CEA of 2.0 micrograms per litre(0-8)but an elevated CA 125 of 94 units per millilitre(0-34). An abdominal/pelvic ultrasound revealed an encapsulated ovoid mass consistent with appearances of a left primary ovarian carcinoma. No liver involvement was noted. Isotope bone scan was normal. Computerised tomography confirmed a left ovarian mass with possible left iliac lymph node involvement. She underwent a laparotomy with the left and right ovaries being removed together with the left iliac nodes. Histology revealed clear cell carcinoma of the left ovary, a normal right ovary and reactive changes to the iliac nodes only. Post-operatively her corrected calcium normalised to 2.26 millimoles per litre(2.1-2.6). She was graded as having stage 1c clear cell carcinoma of the ovary and subsequently had carboplatin chemotherapy. She has remained well post-operatively with no recurrence of her hypercalcaemia. This case demonstrates that clear cell carcinoma of the ovary is an uncommon but recognised cause of hypercalcaemia.