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CC BY 4.0 · AJP Rep 2025; 15(04): e175-e180
DOI: 10.1055/a-2764-3698
Case Report

Aggressive Chemotherapy and Antepartum Management of Small-Cell Carcinoma of the Ovary of Hypercalcemic Type: A Novel Case Report with Ethical and Medical Decision-Making Consideration

Autor*innen

  • Hind N. Moussa

    1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio, United States
    2   Department of Maternal Fetal Medicine, Maternal Fetal Medicine, Kettering Health, Kettering, Ohio, United States

  • Dana Rector 

    3   Department of Obstetrics and Gynecology, University of Toledo and ProMedica Toledo Hospital, Toledo, Ohio, United States

  • Wesley Gherman

    4   Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio, United States

  • Eric Shuffle

    3   Department of Obstetrics and Gynecology, University of Toledo and ProMedica Toledo Hospital, Toledo, Ohio, United States

  • Robert Fresch 

    1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio, United States
    2   Department of Maternal Fetal Medicine, Maternal Fetal Medicine, Kettering Health, Kettering, Ohio, United States

  • Thomas Reid

    1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio, United States
    2   Department of Maternal Fetal Medicine, Maternal Fetal Medicine, Kettering Health, Kettering, Ohio, United States
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Abstract

Background

Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare, aggressive, and highly fatal gynecologic malignancy with few treatment guidelines offered in nonpregnant patients.

Case Report

A 32-year-old woman presented for initial prenatal care at 9 weeks and her dating ultrasound was notable for a large complex adnexal mass. Magnetic resonance imaging performed 2 weeks later revealed accelerated interval growth with possible malignant etiology. She underwent surgical evaluation with salpingo-oophorectomy. Pathology noted signature features of SCCOHT. The patient desired expectant management and declined termination of pregnancy or chemotherapy. Four weeks later, she developed severe abdominal pain, nausea, and vomiting, and she was diagnosed with extensive metastatic disease. After multidisciplinary and multi-institutional counseling, she elected for continuation of her pregnancy and 6-agent chemotherapy including Vinblastine, Cisplatin, Cyclophosphamide, Bleomycin, Doxorubicin, Etoposide (VPCBAE) with close antepartum surveillance. The patient completed multiple rounds of chemotherapy and subsequently delivered via primary cesarean at 272/7 weeks due to maternal sepsis and nonreassuring fetal status. Maternal and neonatal death occurred approximately 1-week postpartum.

Conclusion

This is the first known case of SCCOHT in which the pregnancy was continued through an aggressive chemotherapy regimen.

Keywords

small-cell carcinoma of the ovary - hypercalcemic type - chemotherapy - biomedical ethics


Publikationsverlauf

Eingereicht: 08. August 2025

Angenommen: 04. Dezember 2025

Accepted Manuscript online:
11. Dezember 2025

Artikel online veröffentlicht:
29. Dezember 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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