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Metastatic SMARCA4-deficient undifferentiated tumor in the small mesentery: case report
Shuai Luo1, Xiaoxue Tian1, Ting Xu1
1Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China.
Background:
SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare and highly malignant primary tumor characterized by the loss of SMARCA4 expression. Despite advancements in oncology, diagnosing and treating SMARCA4-UT remain significant clinical challenges.
Case Demonstration:
A 67-year-old male with a history of smoking presented to the hospital with complaints of abdominal distention and pain lasting for more than four days. Abdominal computed tomography (CT) revealed a high-density mass measuring approximately 41 × 37 mm in the right lower quadrant. Additionally, chest CT identified a high-density mass measuring 63 × 48 mm in the upper lobe of the right lung. The patient underwent partial small bowel resection, and postoperative pathological examination confirmed a diagnosis of SMARCA4-UT originating in the small mesentery. Unfortunately, the patient succumbed to respiratory failure 21 days after the diagnosis.
Conclusion:
SMARCA4-UT is an exceedingly rare and aggressive undifferentiated tumor. This case highlights a presentation of SMARCA4-UT with abdominal pain and distention as initial symptoms. Clinicians should consider SMARCA4-UT in middle-aged or elderly male patients with a history of smoking who present with large masses. Comprehensive chest imaging is essential to exclude the thoracic primary disease in such cases.
Insights
SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare, aggressive cancer. This case shows SMARCA4-UT presenting with abdominal pain and distention in a smoker, emphasizing the need for chest imaging.
Area of Science:
- Oncology
- Pathology
Background:
- SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare, highly malignant neoplasm.
- Loss of SMARCA4 expression defines this aggressive tumor type.
- Diagnosis and treatment of SMARCA4-UT present significant clinical challenges.
Observation:
- A 67-year-old male smoker presented with abdominal distention and pain.
- CT revealed masses in the right lower quadrant and right lung.
- Pathology confirmed SMARCA4-UT originating in the small mesentery.
Findings:
- SMARCA4-UT is an exceedingly rare and aggressive undifferentiated tumor.
- This case demonstrates SMARCA4-UT presenting with abdominal symptoms.
- The patient experienced rapid decline, succumbing to respiratory failure.
Implications:
- Clinicians should consider SMARCA4-UT in elderly male smokers with large abdominal masses.
- Comprehensive chest imaging is crucial to rule out concurrent thoracic disease.
- Early recognition and further research are vital for improving outcomes in SMARCA4-UT.
