Desmoplastic small round cell tumor: Imaging pattern of disease at presentation

Ajaykumar Morani, Tharakeswara K Bathala, V. R. Surabhi, Sireesha Yedururi, Corey T Jensen, Winston Huh, Srinivasa Prasad, Andrea Hayes-Jordan

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study is to evaluate the clinical, pathologic, and multimodality cross-sectional imaging features of a cohort of 94 patients with desmoplastic small round cell tumor (DSRCT). MATERIALS AND METHODS. This retrospective study of 94 patients with pathologically verified DSRCT was conducted at a tertiary cancer center between 2001 and 2013. Epi-demiologic, clinical, pathologic, and imaging findings were recorded. Tumor size, location, and shape and the distribution pattern of metastases at presentation were analyzed. RESULTS. DSRCT most often occurred in young patients (median age, 21.5 years; range, 5–53 years), showing a marked predominance in male patients (86 male patients vs eight female patients). Eighty nine-patients (95%) were white (defined in this study as white or Hispanic), four were African American, and one was of Asian descent. Most patients had symptoms, with abdominal pain noted as the most common symptom. At initial presentation, 85 patients (90%) had multifocal disease, nodular disease, diffuse omental and peritoneal disease, or a combination of these conditions. Thirty-eight patients (40%) had diaphragmatic involvement. Thirty-two patients (34%) had liver metastases, and 49 patients (52%) had retroperitoneal involvement in the form of implants, tumoral extension, or nodal involvement. With regard to thoracic findings, 33 patients (35%) had nodal disease, 17 (18%) had pleural effusions, and only two (2%) had lung metastases at presentation. Twelve patients (13%) had calcified lesions. CONCLUSION. DSRCT is a rare, multifocal peritoneal malignancy with frequently disseminated abdominal disease at presentation. In the abdomen, disease most commonly involves the omentum and peritoneum, followed by the retroperitoneum. The liver is the most common solid visceral metastatic site. A substantial number of patients have diaphragmatic involvement. In the thorax, nodal and pleural involvement is more common than lung involvement.

Original languageEnglish (US)
Pages (from-to)W45-W54
JournalAmerican Journal of Roentgenology
Volume212
Issue number3
DOIs
StatePublished - Mar 1 2019

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Desmoplastic Small Round Cell Tumor
Neoplasm Metastasis
Thorax
Peritoneal Diseases
Neoplasms
Lung
Omentum

Keywords

  • Cross-sectional imaging
  • Desmoplastic small round cell tumor
  • Disease pattern

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Desmoplastic small round cell tumor : Imaging pattern of disease at presentation. / Morani, Ajaykumar; Bathala, Tharakeswara K; Surabhi, V. R.; Yedururi, Sireesha; Jensen, Corey T; Huh, Winston; Prasad, Srinivasa; Hayes-Jordan, Andrea.

In: American Journal of Roentgenology, Vol. 212, No. 3, 01.03.2019, p. W45-W54.

Research output: Contribution to journalArticle

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title = "Desmoplastic small round cell tumor: Imaging pattern of disease at presentation",
abstract = "OBJECTIVE. The purpose of this study is to evaluate the clinical, pathologic, and multimodality cross-sectional imaging features of a cohort of 94 patients with desmoplastic small round cell tumor (DSRCT). MATERIALS AND METHODS. This retrospective study of 94 patients with pathologically verified DSRCT was conducted at a tertiary cancer center between 2001 and 2013. Epi-demiologic, clinical, pathologic, and imaging findings were recorded. Tumor size, location, and shape and the distribution pattern of metastases at presentation were analyzed. RESULTS. DSRCT most often occurred in young patients (median age, 21.5 years; range, 5–53 years), showing a marked predominance in male patients (86 male patients vs eight female patients). Eighty nine-patients (95{\%}) were white (defined in this study as white or Hispanic), four were African American, and one was of Asian descent. Most patients had symptoms, with abdominal pain noted as the most common symptom. At initial presentation, 85 patients (90{\%}) had multifocal disease, nodular disease, diffuse omental and peritoneal disease, or a combination of these conditions. Thirty-eight patients (40{\%}) had diaphragmatic involvement. Thirty-two patients (34{\%}) had liver metastases, and 49 patients (52{\%}) had retroperitoneal involvement in the form of implants, tumoral extension, or nodal involvement. With regard to thoracic findings, 33 patients (35{\%}) had nodal disease, 17 (18{\%}) had pleural effusions, and only two (2{\%}) had lung metastases at presentation. Twelve patients (13{\%}) had calcified lesions. CONCLUSION. DSRCT is a rare, multifocal peritoneal malignancy with frequently disseminated abdominal disease at presentation. In the abdomen, disease most commonly involves the omentum and peritoneum, followed by the retroperitoneum. The liver is the most common solid visceral metastatic site. A substantial number of patients have diaphragmatic involvement. In the thorax, nodal and pleural involvement is more common than lung involvement.",
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AU - Jensen, Corey T

AU - Huh, Winston

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AB - OBJECTIVE. The purpose of this study is to evaluate the clinical, pathologic, and multimodality cross-sectional imaging features of a cohort of 94 patients with desmoplastic small round cell tumor (DSRCT). MATERIALS AND METHODS. This retrospective study of 94 patients with pathologically verified DSRCT was conducted at a tertiary cancer center between 2001 and 2013. Epi-demiologic, clinical, pathologic, and imaging findings were recorded. Tumor size, location, and shape and the distribution pattern of metastases at presentation were analyzed. RESULTS. DSRCT most often occurred in young patients (median age, 21.5 years; range, 5–53 years), showing a marked predominance in male patients (86 male patients vs eight female patients). Eighty nine-patients (95%) were white (defined in this study as white or Hispanic), four were African American, and one was of Asian descent. Most patients had symptoms, with abdominal pain noted as the most common symptom. At initial presentation, 85 patients (90%) had multifocal disease, nodular disease, diffuse omental and peritoneal disease, or a combination of these conditions. Thirty-eight patients (40%) had diaphragmatic involvement. Thirty-two patients (34%) had liver metastases, and 49 patients (52%) had retroperitoneal involvement in the form of implants, tumoral extension, or nodal involvement. With regard to thoracic findings, 33 patients (35%) had nodal disease, 17 (18%) had pleural effusions, and only two (2%) had lung metastases at presentation. Twelve patients (13%) had calcified lesions. CONCLUSION. DSRCT is a rare, multifocal peritoneal malignancy with frequently disseminated abdominal disease at presentation. In the abdomen, disease most commonly involves the omentum and peritoneum, followed by the retroperitoneum. The liver is the most common solid visceral metastatic site. A substantial number of patients have diaphragmatic involvement. In the thorax, nodal and pleural involvement is more common than lung involvement.

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