Endocrine Abstracts

We hereby report a rare case of hypercalcemia-associated with dysgerminoma with elevation of 1,25(OH)2 Vitamin D. A 27-year-old nulliparous woman presented with hypercalcemia during examination of a right ovarian tumour. As the serum calcium level increased gradually, she started complaining of nausea and anorexia. The laboratory data at first-visit showed that serum calcium, LDH, ALP, 1,25(OH)2 Vitamin D and fractional excretion of calcium were elevated and intact PTH was suppressed. (serum calcium 13.3 mg/dl, albumin 4.4 g/dl, phosphorous 3.7 mg/dl, LDH 1411 U/l, ALP 399 U/l, intact PTH 6 pg/ml, PTHrP <=1.0 pmol/l, 25(OH) Vitamin D 15.2 ng/ml, 1,25(OH)2 Vitamin D 96.9 pg/ml, FECa 3.51%, BUN 16.6 ng/dl, Creatinine 0.93 mg/dl). Symptomatic hypercalcemia was treated by intravenous normal saline and elcatonin yet medical treatment had a marginal effect. On the 21st-day from the first visit, a right salpingo-oophorectomy was performed. The right ovary measured 13 cm×12.5 cm×3.6 cm. Histopathology of the ovarian mass showed proliferation of large and homogeneous tumour cells with infiltration of small lymphocytes (two cell patterns). Immunohistochemical analysis revealed that tumour cell was PLAP (+, partly), CD117/c-kit(+, weak), D2-40(+), hCG(−), AFP(−). There was no evidence of metastasis, and cytology of the ascetic fluid showed no malignant tumour. Hence this patient was classified in stage pT1apNXpM0 (UICC, 2009) Therefore, she got a follow-up examination every 3-months in the first year without receiving chemotherapy. Postoperatively, serum calcium and 1,25(OH)2 vitamin D returned to normal range within a week. There are numerous causes of hypercalcemia. The case of hypercalcemia associated with dysgerminoma showing elevation of 1,25(OH)2 Vitamin D is still rare, whilst there are several previous reports. We would like to present the case series study of dysgerminoma with hypercalcemia of 15 cases including 14 previous reported ones of database from 1990 to 2018 at the day of the presentation.