Desmoplastic small round cell tumor of stomach

A 23-Year-Old Joradanian Woman with a Desmoplastic Small Round Cell Tumor Involving the Ovary

Patient: Female, 23

Final Diagnosis: Desmoplastic small round cell tumor

Symptoms: Nausea • vomiting • severe abdominal pain of two weeks • weight loss

Medication: —

Clinical Procedure: —

Specialty: Obstetrics and Gynecology

Desmoplastic small round cell tumor in transverse colon: report of a rare case

Desmoplastic small round cell tumor (DSRCT) is an extremely rare, highly aggressive, malignant tumor of undetermined histogenesis. Adolescent males are primarily affected with a typically abdominal or pelvic mass. Diagnosis is based on histologic analysis of biopsy and cytogenetic studies. Owing to the rarity of the tumor and the unusually aggressive presentation, treatment is challenging and has not been standardized. DSRCT has a very poor prognosis, with a median survival range of 17 to 25 months. In this work, we report a case of DSRCT in the transverse colon, which has never before been reported in the literature. Our case study is of a 30-year-old Chinese female who presented with a history of 6 months abdominal discomfort and fatigue. A palpable, hardly mobile mass was detected in the right lower quadrant abdomen by physical examination. Abdominal and pelvic magnetic resonance imaging revealed an 8.0 × 10.5 × 11.1-cm mass with no pulmonary and hepatic metastasis. The patient underwent exploratory laparotomy and transverse colectomy, which revealed a mass in the transverse colon and no metastasis in the peritoneum, greater omentum, or mesentery. Immunohistochemistry findings revealed positive staining for epithelial, mesenchymal, and neural markers, which confirmed the presentation of DSRCT. A 6-month postoperative follow-up failed to find any recurrence. DSRCT is a highly aggressive, malignant, mesenchymal tumor with a very poor prognosis. No consensus has been reached for the treatment protocol of DSRCT. However, debulking surgery with postoperative chemotherapy or radiotherapy might promise more optimistic results on survival.

DESMOPLASTIC SMALL ROUND BLUE CELL TUMOUR OF THE ABDOMEN - A CASE REPORT

Desmoplastic Small Round Cell Tumour (DSRCT) is an uncommon malignant type of Small Round Blue Cell tumours with less than 200 cases reported in literature. Notorious for its aggressiveness, its commonest site of affectation is the abdomen, with a predilection for peritoneal cavity and prone to spread to multiple organs. We report a case of a 26-year old male undergraduate who presented with a 6-month history of progressive abdominal swelling associated with abdominal pain, weight loss, and change in bowel habits. He was cachectic with dyspnoea, bilateral pitting pedal oedema, a grossly distended and a palpable huge firm mass measuring 20 x 15cm. Immunohistochemisttry confirmed a diagnosis of DSRCT. An abdominopelvic Computed Tomography (CT) scan showed extensive abdominal and pelvic disease with pulmonary and liver metastases. He could only tolerate one course of chemotherapy due to deteriorating renal function. It ran an aggressive course of 9 months from onset of symptoms to eventual demise of the patient.

CONCLUSION

Desmoplastic Small Round Blue Cell Tumour is an uncommon and fatal disease, with no significant improvement in survival despite aggressive multimodality therapy. A high index of suspicion and Immunohistochemistry for accurate diagnosis as well as prompt and effective treatment will improve outcome.

A Rare Case of Metastatic Desmoplastic Small Round Cell Tumour: Diagnosis and Management

A 26-year-old male without any significant past medical history presented to the hospital with shortness of breath, cough, pleuritic chest pain, and weight loss for the past 3 months. On chest CT, he was found to have extensive mediastinal and hilar lymphadenopathy and multiple pulmonary nodules. On physical examination, a right groin mass was noted which had been slowly growing for the past 2 years. Ultrasound of the groin showed complex solid mass with internal vascular channels. CT guided biopsy of the mass showed desmoplastic small round cell tumour. His hospital course was complicated by hypoxic respiratory failure requiring emergent intubation and ICU admission where he completed one cycle of vincristine, cyclophosphamide, and doxorubicin with subsequent improvement, followed by extubation. His condition continued to improve after second cycle of chemotherapy and he was ultimately discharged in a stable condition to continue outpatient chemotherapy after a 2-month inpatient stay.