Background: Small cell carcinoma of the ovary is a rare, highly malignant tumor that often exhibits a paraneoplastic hypercalcemia.
Case: A 27-year-old female presented with pancreatitis and altered mental status with hypercalcemia. Further investigation revealed a left ovarian mass and a small cell carcinoma of the ovary, hypercalcemic type was found. Hysterectomy with bilateral salpingo-oophorectomy was performed, and the patient underwent chemotherapy with carboplatin and paclitaxel. Hypercalcemia resolved after tumor resection. The patient has retroperitoneal lymph node recurrence at 16 months.
Conclusion: Paraneoplastic hypercalcemia may result in pancreatitis and delirium. Small cell carcinoma of the ovary should be considered under these circumstances.