Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6175-6183
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6175
Postoperative multiple metastasis of clear cell sarcoma-like tumor of the gastrointestinal tract in adolescent: A case report
Wen-Peng Huang, Li-Ming Li, Jian-Bo Gao
Wen-Peng Huang, Li-Ming Li, Jian-Bo Gao, Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Huang WP acquired and analysed of the work, drafted the manuscript, imaging data collection and analysis; Li LM edited the manuscript; Gao JB wrote and reviewed and edited the manuscript; all authors met the requirements for authorship for the submitted version and agreed to its submission.
Informed consent statement: The study was approved by the Institutional Review Board at The First Affiliated Hospital of Zhengzhou University. Participant gave written consent to participate in the study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Bo Gao, PhD, Academic Research, Chairman, Chief Doctor, Instructor, Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou 450052, Henan Province, China. jianbogaochina@163.com
Received: November 3, 2021
Peer-review started: November 3, 2021
First decision: November 19, 2021
Revised: November 25, 2021
Accepted: March 29, 2022
Article in press: March 29, 2022
Published online: June 26, 2022
Processing time: 225 Days and 10 Hours
Abstract
BACKGROUND

Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLGT) is a rare malignant gastrointestinal mesenchymal soft tissue tumor. Its genetic feature is EWSR1 gene rearrangement. Histologically, it is often accompanied by a varying number of CD68-positive osteoclast-like giant cells. CCSLGT mostly occurs in the small intestinal wall of young people and children. In terms of clinical manifestations, there is no significant difference between it and other gastrointestinal tumors, and the diagnosis depends on immunohistochemistry and gene detection.

CASE SUMMARY

A 16-year-old man developed dizziness and fatigue 2 mo ago, and 10 d ago showed progressive exacerbation of paroxysmal epigastric pain and stopped flatulence and defecation. Computed tomography showed a soft tissue mass in the distal ileum. After complete resection of the lesion, it was diagnosed by combined immunohistochemical and genetic examination as CCSLGT. After surgery, the patient gradually developed lymph node, liver, lung, bone, left thigh, pleura and adrenal metastasis. The survival time was 4 years and 8 mo.

CONCLUSION

Whole abdominal computed tomography enhancement is recommended for patients with gastrointestinal symptoms. There is no effective treatment for CCSLGT with multiple metastases via the lymphatic system and bloodstream after surgical resection.

Keywords: Clear cell sarcoma-like tumor of the gastrointestinal tract; Metastasis; X-ray computed tomography; Case report

Core Tip: Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLGT) is a rare malignant mesenchymal tumor with unique morphological, immunophenotypic and molecular genetic characteristics. Its clinical manifestations are unspecific, and the diagnosis depends on immunohistochemistry and gene testing. Positron emission tomography/computed tomography is recommended for patients with CCSLGT, which can provide functional and metabolic information in addition to anatomical information, and effectively reduce missed lesions. Currently, there is no effective treatment for CCSLGT.