Pediatric ovarian dysgerminoma presenting with hypercalcemia and chronic constipation: a case report.

Published on Oct 1, 2013in Journal of Pediatric Hematology Oncology1.289
· DOI :10.1097/MPH.0B013E31829BCAF1
Mona Nourani1
Estimated H-index: 1
,
Ricarchito Manera5
Estimated H-index: 5
Sources
Abstract
Malignancy-associated hypercalcemia is a common finding among adult malignancies. However, the incidence of malignancy-induced hypercalcemia associated with germ cell tumor among pediatric patients is very rare. We describe a 9-year-old girl with an ovarian dysgerminoma presenting with chronic constipation and hypercalcemia. We review some of the causes of malignancy-associated hypercalcemia described in literature and treatment strategies. We also recommend considering oncological processes in the presence of hypercalcemia.
References8
Newest
#1Chao Yang (CQMU: Chongqing Medical University)H-Index: 6
#2Shan WangH-Index: 1
Last. Jun OuyangH-Index: 2
view all 6 authors...
PURPOSE: Ovarian germ cell tumors are rare in childhood. The goal of the study is to provide information that may help guide the evaluation and surgical management of future children with ovarian tumors. METHODS: A retrospective review of patients with ovarian germ cell tumors between January 1990 and January 2010 was performed. RESULTS: 137 patients were included with a median age of 9.5 years. Teratomas were found most frequently (mature: 78, immature: 6), followed by yolk sac tumors (n = 51),...
#1Shih-Ming Chu (CGU: Chang Gung University)H-Index: 20
#2Yung Ching Ming (CGU: Chang Gung University)H-Index: 6
Last. Chih Cheng Luo (CGU: Chang Gung University)H-Index: 10
view all 7 authors...
Background: Ovarian tumors have generally been considered rare in the pediatric age group. We reported our experience dealing with pediatric ovarian tumors during an 8-year period. Methods: Between January 1998 and December 2006, 37 girls with ovarian tumors were treated at the Department of Pediatric Surgery, Chang Gung Children’s Medical Center. Modes of clinical presentation, pathology diagnosis, methods of treatment and clinical outcome were retrospectively analyzed. Results: Twenty-nine of ...
#1Hibi Masahito (Fujita Health University)H-Index: 1
#2Fujio Hara (Fujita Health University)H-Index: 9
Last. Ryoichi Kato (Fujita Health University)H-Index: 9
view all 8 authors...
Humoral hypercalcemia of malignancy (HHM) is a rare complication of malignant pediatric tumors, specifically those that secrete humoral factor(s), such as parathyroid hormone-related peptide (PTHrP). The authors report a case of severe hypercalcemia associated with ovarian dysgerminoma in a 10-year-old girl. In this case, the humoral factor was considered to be 1,25-dihydroxyvitamin D. HHM is extremely resistant to medical therapy. Therefore, tumor resection or volume reduction is necessary to c...
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#1Richardson Matthew (Baystate Medical Center)H-Index: 1
#2Otis Christopher (Baystate Medical Center)H-Index: 1
Last. Sprinz Philippa (Baystate Medical Center)H-Index: 1
view all 3 authors...
Hypercalcemia is a rare complication of pediatric malignant germ cell tumors. The problem may be missed because of unawareness among pediatric oncologists. We describe a 16-year-old girl with an ovarian dysgerminoma associated with severe hypercalcemia, a metabolic abnormality infrequently reported with this disease. We review some of the potential causes of malignancy-associated hypercalcemia and current treatment strategies. It is our recommendation that calcium levels should be monitored in a...
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A 47-year-old woman with a history of breast cancer presents with confusion and dehydration. The serum calcium level is 18.0 mg per deciliter. She has postural hypotension and low central venous pressure. The serum phosphorus level is 5.0 mg per deciliter, the blood urea nitrogen level 80 mg per deciliter, the serum creatinine level 2.0 mg per deciliter, and the albumin level 3.3 g per deciliter. Bone scintigraphy reveals no evidence of skeletal involvement by the tumor. How should she be treate...
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Summary: Hypercalcemia is a rare but potentially fatal complication during the management of childhood cancer. The treatment of severe hypercalcemia in children has not been clearly defined. The authors present a retrospective series of 16 children (11 boys and 5 girls) with severe hypercalcemia (≥2.9 mmol/L) treated between 1997 and 2004 for malignancy. Median serum calcium level was 3.14 mmol/L. Hypercalcemia was present at the initial diagnosis of cancer (eight patients) or occurred during tr...
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#1Levato FH-Index: 2
#2Martinello RH-Index: 2
Last. S PortoH-Index: 1
view all 4 authors...
: Lactic Dehydrogenase (LDH) serum levels were evaluated in three patients with ovarian dysgerminoma and LDH isoenzymes only in one of them. LDH serum levels were elevated at diagnosis and normal after therapy in all the patients; remained low in two patients in remission, increased in one at the moment of progression. LDH isoenzymes appeared to be of limited clinical use.
#1Charles McKay (UTHSC: University of Tennessee Health Science Center)H-Index: 1
#2Wayne L. Furman (UTHSC: University of Tennessee Health Science Center)H-Index: 3
Background. Hypercalcemia complicating malignancy is a frequent complication in adults, but little has been published about the pathogenesis or the true incidence of hypercalcemia in children with cancer. Methods. Hypercalcemia developing in childhood malignancies was studied retrospectively at St. Jude Children's Research Hospital to determine its incidence, the timing of its presentation, and its response to therapy. Results. Over a 29-year period, 25 children (median age, 9.5 years) had been ...
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Cited By6
Newest
#1Mihaela Camelia Tîrnovanu (Grigore T. Popa University of Medicine and Pharmacy)H-Index: 1
#2Irina Daniela Florea (Grigore T. Popa University of Medicine and Pharmacy)H-Index: 1
Last. Ludmila Lozneanu (Grigore T. Popa University of Medicine and Pharmacy)H-Index: 7
view all 7 authors...
Ovarian malignant germ cell tumors (OMGCT) represent less than 10% of all ovarian tumors. Dysgerminoma is the most common malignant primitive germ cell tumor in young women, known for its curability and low propensity to invade and metastasize when diagnosed early. Herein, we report an unusual type of ovarian dysgerminoma (OD) metastasis with a brief review of the literature, lacking similar reported cases. To our knowledge, although there are several case reports of dysgerminoma metastases with...
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#1Mark Kilbane (UCD: University College Dublin)H-Index: 13
#2Rachel K CrowleyH-Index: 17
Last. Patrick J TwomeyH-Index: 24
view all 5 authors...
Parathyroid hormone-related protein (PTHrP) can simulate most of the actions of parathyroid hormone (PTH) including increases in bone resorption and distal tubular calcium reabsorption and inhibition of proximal tubular phosphate transport.1 The low serum phosphate in parallel with low circulating PTH is consistent with PTHrP involvement in this case. Whether it can be causative for a serum calcium of 6.24 mmol/L however is a moot point. While the mechanism underlying the patient’s severe hyperc...
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#1Mohammed Hasosah (King Saud bin Abdulaziz University for Health Sciences)H-Index: 10
Chronic refractory constipation (CRC) is defined as children who are unable to pass stools in spite of being on maximum laxative therapy and require daily rectal stimulation in the form of enemas or suppositories to pass stools for >3 months. Children are often referred for treatment of refractory constipation that may result from uncontrolled underlying disease or ineffective treatment. Constipated children can be managed by a variety of medical therapeutic options that yield satisfying results...
Source
#1Fabiola MedeirosH-Index: 1
#2Kyle C. StricklandH-Index: 16
Abstract Germ cell tumors of the ovary are presumed to derive from the pathogenic transformation of ovarian germ cells at different stages of development. Germ cell tumors account for 20% to 25% of all ovarian neoplasms in females. The great majority are mature teratomas, which are benign. Only 3% to 5% of all germ cell tumors in females are malignant, of which the majority are dysgerminomas, immature teratomas, and yolk sac tumors in a pure form or as part of a mixed germ cell tumor, all occurr...
Source
#1Victoria Stokes (University of Oxford)H-Index: 6
#2Morten F Nielsen (University of Oxford)H-Index: 1
Last. Rajesh V. Thakker (University of Oxford)H-Index: 96
view all 4 authors...
: Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness ...
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#1Francisco F. Nogales (UGR: University of Granada)H-Index: 28
#2Maolly Schuldt (UGR: University of Granada)H-Index: 5
Germ cell tumors (GCT) of the ovary and other locations in the female genital tract are analyzed from a clinicopathological viewpoint and reconsidered in the light of the latest genetic knowledge of their origin and information from new pluripotency and developmental stage markers.
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