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World J Gastroenterol. Feb 7, 2006; 12(5): 800-803
Published online Feb 7, 2006. doi: 10.3748/wjg.v12.i5.800
Combined resection and multi-agent adjuvant chemotherapy for desmoplastic small round cell tumor arising in the abdominal cavity: Report of a case
Chang-Cheng Chang, Jun-Te Hsu, Jeng-Hwei Tseng, Tsann-Long Hwang, Han-Ming Chen, Yi-Yin Jan
Chang-Cheng Chang, Jun-Te Hsu, Tsann-Long Hwang, Han-Ming Chen, Yi-Yin Jan, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, China
Jeng-Hwei Tseng, Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, China
Correspondence to: Dr Han-Ming Chen, Department of Surgery, En Chu Kong Hospital 399, Fuhsing Road, San-shia Town, Taipei Hsien 237, Taiwan, China. ming1838@yahoo.com
Telephone: +886-3-3281200- 3219 Fax: +886-3-3285818
Received: June 28, 2005
Revised: June 28, 2005
Accepted: July 15, 2005
Published online: February 7, 2006
Abstract

Desmoplastic small round cell tumor (DSRCT) is a rare, highly aggressive malignancy with distinctive histological features: a nesting pattern of cellular growth within dense desmoplastic stroma, occurring in young population with male predominance. The mean survival period is only about 1.5-2.5 years. The tumor has co-expressed epithelial, muscle, and neural markers in immunohistochemical studies. This work reports a 27-year-old man presenting with hematemesis and chronic constipation. Serial studies including endoscopy, upper gastrointestinal series, abdominal computed tomography and barium enema study showed disseminated involvement of visceral organs. The patient underwent aggressive surgery and received postoperative adjuvant chemotherapy consisting of 5-fluorouracil, cyclophosphamide, etoposide, doxorubicin, and cisplatin. He survived without any disease for 20 mo after the surgery. No standard treatment protocol has been established. Aggressive surgery combined with postoperative multi-agent adjuvant chemotherapy is justified not only to relieve symptoms but also to try to improve the outcome in this advanced DSRCT young patient.

Keywords: Desmoplastic small round cell tumor, Surgery, Chemotherapy