This variant of primary small cell carcinoma of the ovary is more common than the pulmonary type. It is a high-grade tumor, usually bilateral, and affects young females. It is associated with hypercalcemia in 60% to 70% of cases. The tumor cells are small with scant cytoplasm and arranged in cords, trabeculae, and follicle-like structures. Larger pleomorphic cells may also be present in some cases.