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Desmoplastic small round cell tumor: postoperative retroperitoneal mass
Colette J Shen1, David M Loeb2, Stephanie A Terezakis1
1Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 401 North Broadway St., Suite 1440, Baltimore, MD, 21287, USA.
Radiology Case Reports
|September 6, 2016
Summary
A large postoperative mass in a desmoplastic small round cell tumor (DSRCT) patient was a benign fluid collection, not recurrent cancer. Early identification is crucial for successful adjuvant therapy.
Area of Science:
- Oncology
- Radiology
- Surgical Pathology
Background:
- Desmoplastic small round cell tumor (DSRCT) is an aggressive malignancy often presenting with metastatic disease.
- Complete surgical resection is a critical component of DSRCT management.
- Postoperative imaging can be challenging due to potential for benign changes mimicking recurrence.
Observation:
- A 14-year-old boy with DSRCT developed a large, heterogeneous retroperitoneal mass post-surgery.
- Initial concerns for tumor recurrence were high due to the mass size and positive surgical margins.
- Advanced imaging revealed the mass was a simple fluid collection without contrast enhancement.
Findings:
- The heterogeneous mass was definitively identified as a postoperative fluid collection, not a neoplastic recurrence.
- Accurate radiological assessment prevented misdiagnosis and unnecessary escalation of treatment.
- The patient successfully continued planned adjuvant therapy.
Implications:
- Large postoperative heterogeneous masses in DSRCT patients can represent benign fluid collections.
- Distinguishing fluid collections from tumor recurrence is vital for appropriate treatment planning.
- Timely diagnosis of benign postoperative changes ensures adherence to adjuvant therapy protocols, potentially improving outcomes.
