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CHEN JINGJING, WU ZENGJIE, SUN BINBIN, LI DACHENG, WANG ZHENGUANG, LIU FANGJUN, HUA HUI. Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association. Oncol Lett 2016; 11:3298-3302. [PMID: 27123106 PMCID: PMC4840839 DOI: 10.3892/ol.2016.4421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 01/08/2016] [Indexed: 11/11/2022] Open
Abstract
Desmoplastic small round cell tumors (DSRCTs) are rare and aggressive malignant tumors. The aim of the present study was to analyze computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT imaging features of intra-abdominal desmoplastic DSRCT, and investigate the association of these features with histopathological results. The present study was a retrospective investigation of 4 patients with DSRCT. All patients underwent CT and dynamic CT, and 1 additionally underwent FDG-PET/CT scanning. Following a tumor resection, routine hematoxylin and eosin staining, and immunostaining, were performed and evaluated. Multiple large abdominopelvic masses were identified in all 4 patients; however, no indications of their site of origin were demonstrated. CT revealed soft-tissue masses with patchy foci of hypodense lesions. Contrast-enhanced CT revealed slightly or moderately heterogeneous enhancement of the lesions. Other observations from these patients included calcification (n=2), peritoneal seeding (n=3), hepatic metastasis (n=3), retroperitoneal lymphadenopathy (n=3) and ascites (n=2). FDG-PET/CT revealed multiple nodular increased FDG uptake in the abdominopelvic masses, and in the liver and peritoneum in 1 case. Intra-abdominal DSRCT demonstrated significant diagnostic characteristics on plain and contrast-enhanced CT. Multiple, bulky soft-tissue masses inside the peritoneal cavity, particularly in male adolescents and young adults, should be considered as potential cases of DSRCT. FDG-PET/CT techniques may be utilized to aid the staging of tumors.
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Affiliation(s)
- JINGJING CHEN
- Department of Radiology, The Affiliated Hospital of Qingdao University, Shandong 266003, P.R. China
| | - ZENGJIE WU
- Department of Positron Emission Tomography/Computed Tomography, Qingdao Center Medical Group, Shandong 266042, P.R. China
| | - BINBIN SUN
- Department of Diagnostic Ultrasound, Affiliated Zhucheng People's Hospital, Weifang Medical University, Shandong 262200, P.R. China
| | - DACHENG LI
- Department of Positron Emission Tomography/Computed Tomography, The Affiliated Hospital of Qingdao University, Shandong 266003, P.R. China
| | - ZHENGUANG WANG
- Department of Positron Emission Tomography/Computed Tomography, The Affiliated Hospital of Qingdao University, Shandong 266003, P.R. China
| | - FANGJUN LIU
- Institute of Plastic Surgery, Weifang Medical University, Shandong 261042, P.R. China
| | - HUI HUA
- Department of Otorhinolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Shandong 266003, P.R. China
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Liu Q, Liu N, Chen D. Primary desmoplastic small round cell tumor of the duodenum. Eur J Med Res 2014; 19:38. [PMID: 24997683 PMCID: PMC4096735 DOI: 10.1186/2047-783x-19-38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 06/25/2014] [Indexed: 11/10/2022] Open
Abstract
The desmoplastic small round cell tumor (DSRCT) is an extremely rare tumor that mainly affects adolescents and mostly involves the abdominal and pelvic peritoneum. A 14-year-old girl presented with intermittent epigastric pain; abdominal computed tomography and upper gastrointestinal barium X-ray revealed an 8 cm × 10 cm space-occupying mass in the duodenal region. The patient underwent pancreaticoduodenectomy and the final pathologic diagnosis was DSRCT. Although multi-agent systemic chemotherapy was given, the patient died of metastasis 8 months later. Early diagnosis and surgical treatment with adjuvant chemotherapy seems to be the best treatment choice for this disease.
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Affiliation(s)
| | | | - DeXing Chen
- General Surgery Department, Qian Wei Hospital of Jilin province, Changchun City, Jilin Province, China.
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3
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Kim HJ, Sohn BS, Kwon JE, Kim JY, Park K. ThinPrep Cytological Findings of Desmoplastic Small Round Cell Tumor with Extensive Glandular Differentiation: A Case Study. KOREAN JOURNAL OF PATHOLOGY 2013; 47:182-7. [PMID: 23667380 PMCID: PMC3647133 DOI: 10.4132/koreanjpathol.2013.47.2.182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 11/28/2012] [Accepted: 12/17/2012] [Indexed: 12/20/2022]
Abstract
Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive neoplasm. The cytological diagnosis of this tumor has only been reported in a few cases. In most of these cases, the diagnosis was made using fine-needle aspiration cytology. Most DSRCTs resemble disseminated carcinomatoses in their clinical manifestation as well as cytomorphologically, even in young-adult patients. These authors report a case of using peritoneal-washing and pleural-effusion ThinPrep cytology to diagnose DSRCT, with extensive glandular differentiation and mucin vacuoles. We found that fibrillary stromal fragment, clinical setting, and adjunctive immunocytochemical staining were most helpful for avoiding misdiagnosis.
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Affiliation(s)
- Hyun-Jung Kim
- Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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4
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Khalbuss WE, Bui M, Loya A. A 19-Year-Old Woman With a Cervicovaginal Mass and Elevated Serum CA 125. Arch Pathol Lab Med 2006; 130:e59-61. [PMID: 16594762 DOI: 10.5858/2006-130-e59-aywwac] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Walid E Khalbuss
- Department of Pathology, University of Florida Health Science Center, Jacksonville, USA.
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5
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Yamaguchi U, Hasegawa T, Morimoto Y, Tateishi U, Endo M, Nakatani F, Kawai A, Chuman H, Beppu Y, Endo M, Kurotaki H, Furuta K. A practical approach to the clinical diagnosis of Ewing's sarcoma/primitive neuroectodermal tumour and other small round cell tumours sharing EWS rearrangement using new fluorescence in situ hybridisation probes for EWSR1 on formalin fixed, paraffin wax embedded tissue. J Clin Pathol 2005; 58:1051-6. [PMID: 16189150 PMCID: PMC1770737 DOI: 10.1136/jcp.2004.025502] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Over 90% of Ewing's sarcoma/primitive neuroectodermal tumour (ES/PNET) cases have the t(11;22) chromosomal rearrangement, which is also found in other small round cell tumours, including desmoplastic small round cell tumour (DSRCT) and clear cell sarcoma (CCS). Although this rearrangement can be analysed by fluorescence in situ hybridisation (FISH) using routinely formalin fixed, paraffin wax embedded (FFPE) tissues when fresh or frozen tissues are not available, a sensitive and convenient detection method is needed for routine clinical diagnosis. AIMS To investigate the usefulness of newly developed probes for detecting EWS rearrangement resulting from chromosomal translocations using FISH and FFPE tissue in the clinical diagnosis of ES/PNET, DSRCT, and CCS. METHODS Sixteen ES/PNETs, six DSRCTs, and six CCSs were studied. Three poorly differentiated synovial sarcomas, three alveolar rhabdomyosarcomas, and three neuroblastomas served as negative controls. Interphase FISH analysis was performed on FFPE tissue sections with a commercially available EWSR1 (22q12) dual colour, breakapart rearrangement probe. RESULTS One fused signal and one split signal of orange and green, demonstrating rearrangement of the EWS gene, was detected in 14 of 16 ES/PNETs, all six DRSCTs, and five of six CCSs, but not in the negative controls. CONCLUSIONS Interphase FISH using this newly developed probe is sensitive and specific for detecting the EWS gene on FFPE tissues and is of value in the routine clinical diagnosis of ES/PNET, DSRCT, and CCS.
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MESH Headings
- Adolescent
- Adult
- Aged
- Bone Neoplasms/diagnosis
- Bone Neoplasms/genetics
- Calmodulin-Binding Proteins/genetics
- Child
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 22/genetics
- DNA Probes
- Female
- Formaldehyde
- Gene Rearrangement
- Humans
- In Situ Hybridization, Fluorescence
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Neuroectodermal Tumors, Primitive, Peripheral/diagnosis
- Neuroectodermal Tumors, Primitive, Peripheral/genetics
- Paraffin Embedding
- RNA-Binding Protein EWS
- RNA-Binding Proteins/genetics
- Reverse Transcriptase Polymerase Chain Reaction/methods
- Sarcoma, Clear Cell/diagnosis
- Sarcoma, Clear Cell/genetics
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Translocation, Genetic
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Affiliation(s)
- U Yamaguchi
- Division of Orthopaedic Oncology, National Cancer Centre Hospital and Research Institute, Tokyo 104-0045, Japan
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Granja NM, Begnami MD, Bortolan J, Filho AL, Schmitt FC. Desmoplastic small round cell tumour: Cytological and immunocytochemical features. Cytojournal 2005; 2:6. [PMID: 15777480 PMCID: PMC555739 DOI: 10.1186/1742-6413-2-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 03/18/2005] [Indexed: 11/25/2022] Open
Abstract
Background Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive neoplasm. The cytological diagnosis of these tumors can be difficult because they show morphological features quite similar to other small round blue cells tumors. We described four cases of DSRCT with cytological sampling: one obtained by fine needle aspiration biopsy (FNAB) and three from serous effusions. The corresponding immunocytochemical panel was also reviewed. Methods Papanicolaou stained samples from FNAB and effusions were morphologically described. Immunoreaction with WT1 antibody was performed in all cytological samples. An immunohistochemical panel including the following antibodies was performed in the corresponding biopsies: 34BE12, AE1/AE3, Chromogranin A, CK20, CK7, CK8, Desmin, EMA, NSE, Vimentin and WT1. Results The smears showed high cellularity with minor size alteration. Nuclei were round to oval, some of them with inconspicuous nucleoli. Tumor cells are clustered, showing rosette-like feature. Tumor cells in effusions and FNA were positive to WT1 in 3 of 4 cytology specimens (2 out 3 effusions and one FNA). Immunohistochemical reactions for vimentin, NSE, AE1/AE3 and WT1 were positive in all cases in tissue sections. Conclusion The use of an adjunct immunocytochemical panel coupled with the cytomorphological characteristics allows the diagnosis of DSRCT in cytological specimens.
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Affiliation(s)
- Nara M Granja
- Pathology Department, School of Medicine, São Paulo University, São Paulo, Brazil
| | - Maria D Begnami
- Department of Pathology and Treatment and Research Center of A.C. Camargo Hospital, São Paulo, Brazil
| | - Jeni Bortolan
- Department of Pathology and Treatment and Research Center of A.C. Camargo Hospital, São Paulo, Brazil
| | - Adhemar Longatto Filho
- Life and Health Sciences Research Institute, Health Sciences School, University of Minho, Braga, Portugal
- Pathology Division, Adolfo Lutz Institute, São Paulo, Brazil
| | - Fernando C Schmitt
- Medical Faculty, Department of Pathology, University of Porto, Porto, Portugal
- IPATIMUP – Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal
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7
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Sandberg AA, Bridge JA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors. desmoplastic small round-cell tumors. CANCER GENETICS AND CYTOGENETICS 2002; 138:1-10. [PMID: 12419577 DOI: 10.1016/s0165-4608(02)00680-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Avery A Sandberg
- Department of DNA Diagnostics, St. Joseph's Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013, USA.
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8
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The diagnostic use of cytogenetic and molecular genetic techniques in the assessment of small round cell tumours. ACTA ACUST UNITED AC 2002. [DOI: 10.1054/cdip.2002.0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Syed S, Haque AK, Hawkins HK, Sorensen PHB, Cowan DF. Desmoplastic Small Round Cell Tumor of the Lung. Arch Pathol Lab Med 2002; 126:1226-8. [PMID: 12296765 DOI: 10.5858/2002-126-1226-dsrcto] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
An extra-abdominal desmoplastic small round cell tumor (DSRCT) of the lung with immunohistochemical, ultrastructural, and cytogenetic evidence of multidirectional differentiation is reported. We demonstrate that DSRCTs of the lung and pleura show morphologic, molecular, genetic, and ultrastructural features similar to DSRCTs arising in other sites. The tumor showed coexpression of cytokeratins (AE1/3, epithelial membrane antigen, CAM 5.2) and mesenchymal markers (vimentin, desmin, neuron-specific enolase), as well as WT1. Ultrastructurally, intracytoplasmic whorls of intermediate filaments, similar to previous descriptions of DSRCT in nonthoracic sites, were also demonstrated in this case. EWS-WT1 gene fusion characteristic of DSRCT with the t(11;22)(q13;q12) translocation was demonstrated in this tumor.
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MESH Headings
- Adult
- Biomarkers, Tumor/analysis
- Carcinoma, Small Cell/chemistry
- Carcinoma, Small Cell/genetics
- Carcinoma, Small Cell/pathology
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 22
- DNA, Neoplasm/analysis
- Desmin/analysis
- Humans
- Intermediate Filaments/ultrastructure
- Lung Neoplasms/chemistry
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Male
- Neoplasm Proteins/analysis
- Oncogene Proteins, Fusion/analysis
- Oncogene Proteins, Fusion/genetics
- Radiography, Thoracic
- Reverse Transcriptase Polymerase Chain Reaction
- Tomography, X-Ray Computed
- Translocation, Genetic
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Affiliation(s)
- Salahuddin Syed
- Department of Pathology, University of Texas Medical Branch, Galveston 77555, USA
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10
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Hill DA, O'Sullivan MJ, Zhu X, Vollmer RT, Humphrey PA, Dehner LP, Pfeifer JD. Practical application of molecular genetic testing as an aid to the surgical pathologic diagnosis of sarcomas: a prospective study. Am J Surg Pathol 2002; 26:965-77. [PMID: 12170083 DOI: 10.1097/00000478-200208000-00001] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The strong correlation of specific reciprocal translocations with individual tumor types and the demonstration that polymerase chain reaction (PCR)-based methods can detect translocations in tissue samples have stimulated interest in the role of molecular genetic testing in diagnostic surgical pathology. To evaluate the clinical utility of PCR-based molecular analysis of soft tissue neoplasms in routine surgical pathology, 131 consecutive soft tissue tumors submitted for molecular genetic testing at a tertiary care teaching hospital were prospectively analyzed over a 36-month period. RT-PCR was used to test tumor RNA for fusion transcripts characteristic of malignant round cell tumors (including Ewing sarcoma/primitive neuroectodermal tumor, desmoplastic small round cell tumor, and alveolar rhabdomyosarcoma), spindle cell tumors (including synovial sarcoma and congenital fibrosarcoma), and fatty tumors (myxoid liposarcoma). DNA sequence analysis was used to confirm the identity of all PCR products, and the PCR results were compared with the histopathologic diagnosis. We found that sufficient RNA for RT-PCR-based testing was recovered from 96% of the 131 cases and the percentage of tumors that tested positive for the associated characteristic fusion transcript was in general agreement with those reported in the literature. DNA sequence analysis of PCR products identified both variant transcripts and spurious PCR products, underscoring the value of product confirmation steps when testing formalin-fixed, paraffin-embedded tissue. Only in rare cases did testing yield a genetic result that was discordant with the histopathologic diagnosis. We conclude that PCR-based testing is a useful adjunct for the diagnosis of malignant small round cell tumors, spindle cell tumors, and other miscellaneous neoplasms in routine surgical pathology practice.
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MESH Headings
- Base Sequence
- Humans
- Liposarcoma, Myxoid/diagnosis
- Liposarcoma, Myxoid/genetics
- Polymerase Chain Reaction
- Prospective Studies
- RNA, Neoplasm/analysis
- Rhabdomyosarcoma, Alveolar/diagnosis
- Rhabdomyosarcoma, Alveolar/genetics
- Rhabdomyosarcoma, Alveolar/pathology
- Sarcoma/diagnosis
- Sarcoma/genetics
- Sarcoma/pathology
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/pathology
- Sarcoma, Small Cell/diagnosis
- Sarcoma, Small Cell/genetics
- Sarcoma, Small Cell/pathology
- Sarcoma, Synovial/diagnosis
- Sarcoma, Synovial/genetics
- Sarcoma, Synovial/pathology
- Soft Tissue Neoplasms/diagnosis
- Soft Tissue Neoplasms/genetics
- Soft Tissue Neoplasms/pathology
- Translocation, Genetic
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Affiliation(s)
- D Ashley Hill
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital, Washington University Medical Center, St. Louis, MO, USA
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11
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Mihok NA, Cha I. Desmoplastic small round cell tumor presenting as a neck mass: a case report. Diagn Cytopathol 2001; 25:68-72. [PMID: 11466817 DOI: 10.1002/dc.2005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An unusual case study of a desmoplastic small round cell tumor presenting as a 3.5-cm, firm, supraclavicular neck mass and diagnosed by fine-needle aspirate biopsy in a 16-yr-old male is reported. Clinical, cytologic, and immunocytochemical findings are described. Histologic, immunohistochemical, and genetic features are discussed. Desmoplastic small round cell tumor should be considered in the differential diagnosis of small round cell tumors of any site; the importance of ancillary studies in arriving at the correct diagnosis is emphasized.
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Affiliation(s)
- N A Mihok
- Department of Surgical Pathology, University of California, San Francisco, California, 94143, USA
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Kurre P, Felgenhauer JL, Miser JS, Patterson K, Hawkins DS. Successful dose-intensive treatment of desmoplastic small round cell tumor in three children. J Pediatr Hematol Oncol 2000; 22:446-50. [PMID: 11037858 DOI: 10.1097/00043426-200009000-00012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Desmoplastic small round cell tumor (DSRCT) is a rare soft tissue tumor of primitive origin occurring primarily in children and young adults. Based on published reports in the literature, the response to conventional chemotherapy is poor. We report three pediatric patients successfully treated with dose-intensive, multimodal therapy. Between August 1994 and March 1998, we evaluated three consecutive patients with DSRCT at Children's Hospital and Regional Medical Center, Seattle, Washington. We established the diagnosis based on clinical presentation, radiologic staging, and pathologic review with immunohistochemical staining. All patients received a combined modality protocol including dose-intensive chemotherapy (two of them with peripheral blood stem cell [PBSC] support), second look surgery, and consolidative local irradiation. The patients remain in continuous remission at 66, 42, and 26 months after diagnosis, respectively. Two of our patients were younger than any previously reported patient, extending the age group for which DSRCT should be considered on diagnosis of small round cell tumors. The uniform survival achieved in our series indicates potential benefit for the combination of dose-intensive multiagent chemotherapy, local irradiation, and aggressive surgical approach in this disease.
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Affiliation(s)
- P Kurre
- Children's Hospital and Regional Medical Center, University of Washington, Department of Pediatrics, Seattle 98105, USA
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