Small cell carcinoma of the ovary with hypercalcemia causes severe pancreatitis and altered mental status

Small cell carcinoma of the ovary is a rare, highly malignant tumor that often exhibits a paraneoplastic hypercalcemia. 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. Paraneoplastic hypercalcemia may result in pancreatitis and delirium. Small cell carcinoma of the ovary should be considered under these circumstances.