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This variant of primary small cell carcinoma of the ovary is more common than the pulmonary type. It is a high-grade tumor, often bilateral, and affects young females (average age, 23 years). It is associated with hypercalcemia in 60% to 70% of cases. The tumor cells are small with scant cytoplasm and arranged in closely-packed cords, trabeculae, and follicle-like structures. Larger pleomorphic cells may also be present in some cases.