About Desmoplastic Small Round Cell Tumor
Desmoplastic small round cell tumor (DSRCT) is a rare, highly aggressive malignant neoplasm characterized by pathognomonic EWSR1-WT1 fusion gene resulting from t(11;22)(p13;q12) translocation. The tumor arises in the peritoneum (~80% of cases), pleura, biliary tract, and rarely other sites. Histologically characterized by clusters of small round cells surrounded by prominent desmoplastic stromal reaction.
Typically presents as intra-abdominal mass with peritoneal involvement in adolescents and young adults. The majority of patients present with advanced disease including peritoneal carcinomatosis and distant metastases. The tumor is highly aggressive with historically poor prognosis, though modern multimodal approaches have improved survival. Pathophysiology involves aberrant transcription factor function from the fusion protein, driving aggressive growth and resistance to single-modality therapy.
Diagnosis requires histology plus molecular confirmation of EWSR1-WT1 fusion. Prognosis remains guarded with 5-year survival historically <30%, but combination chemotherapy, complete surgical resection, and radiation therapy offer the best outcomes, with some centers reporting improved survival with aggressive multimodal therapy.
Common Symptoms of Desmoplastic Small Round Cell Tumor
Recognizing the signs of Desmoplastic Small Round Cell Tumor early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Abdominal mass and abdominal distension
- Abdominal pain
- Nausea and vomiting
- Constipation or bowel obstruction
- Weight loss and fatigue
- Metastatic disease in most cases at diagnosis
Who Desmoplastic Small Round Cell Tumor Affects
Predominantly affects adolescents and young adults, with peak incidence at 15-35 years of age. Slight male predominance reported in most series. Can occur in children younger than 15 and rarely in older adults over 50.
No known ethnic, racial, or geographic predisposition. Not associated with hereditary cancer syndromes. Sporadically occurring without familial clustering, though rare familial cases documented.
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