Abstract
Intra-abdominal desmoplastic small round cell tumours are rare aggressive tumours of mesothelial origin with less than 60 cases reported in the literature. They are difficult to treat and the role of 18F-fludeoxyglucose positron emission tomography (PET)/CT scan in their management has not been established. A 41-year-old male presented with a 21-cm desmoplastic small round cell tumour and was managed with radiotherapy, surgery and chemotherapy, with each treatment monitored and guided by 18F-fludeoxyglucose PET/CT scan. We present the imaging findings of the serial PET/CT scans of this patient and their impact on management.
Highlights
CASE REPORT A 41-year-old male was found to have a large abdominal mass that was confirmed through biopsy to be a desmoplastic small round cell tumour (DSRCT)
CT imaging showed an abdominal mass measuring 21 Â 11 Â 14 cm and the patient was treated with one cycle of chemotherapy with cyclophosphamide, adriamycin, vincristine, ifosfamide and etoposide; his mass progressed to 25 Â 16 Â 22 cm. 18F-fludeoxyglucose positron emission tomography (18F-FDG PET)/CT scan showed a mostly necrotic 25-cm abdominal mass with a maximum standardized uptake value (SUVmax) of 18.5 with limited peritoneal disease (Figures 2 and 3), which altered the treatment strategy from curative to palliative, and palliative radiation therapy (RT) was initiated
No consensus has yet been reached concerning the optimal strategy for managing DSRCT.6 18F-FDG PET/CT scan is crucial in the staging of DSRCT,[2,4] and several cases of serial PET/CT
Summary
CASE REPORT A 41-year-old male was found to have a large abdominal mass that was confirmed through biopsy to be a desmoplastic small round cell tumour (DSRCT). 18F-fludeoxyglucose positron emission tomography (18F-FDG PET)/CT scan showed a mostly necrotic 25-cm abdominal mass with a maximum standardized uptake value (SUVmax) of 18.5 with limited peritoneal disease (left pelvic nodule measuring 2.0 Â 1.4 cm with SUVmax of 13.9) (Figures 2 and 3), which altered the treatment strategy from curative to palliative, and palliative radiation therapy (RT) was initiated.
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