Hassan Jacfar, Kieft Aria, Joiner Michael, Miller Steven
Radiation Oncology, Wayne State University School of Medicine, Detroit, USA.
Cureus. 2023 Aug 21;15(8):e43863. doi: 10.7759/cureus.43863. eCollection 2023 Aug.
An early adolescent male presented with six months of nausea, vomiting, and constipation. A chest computed tomography (CT) scan revealed multiple pulmonary nodules of varying sizes and a 3.1 cm pleural-based mass-like density in the right lower pulmonary lobe suspicious for metastatic disease. A CT scan of the abdomen and pelvis revealed diffuse metastatic disease involving the lungs, liver, and peritoneum. An ultrasound (US)-guided core needle biopsy of the liver was performed, and the morphology and immunohistochemistry were consistent with a poorly differentiated carcinoma. Further workup was performed, and the patient was diagnosed with a desmoplastic small round cell tumor (DSRCT). The patient underwent eight cycles of chemotherapy, but his tumor metastasized to distant sites. He then underwent two courses of palliative radiation therapy to the pelvis. His cancer continued to progress, and he eventually succumbed to his disease. This case report evaluates the evidence, data, radiation dosages, and techniques for palliative radiation therapy for DSRCTs.
一名青春期早期男性出现了6个月的恶心、呕吐和便秘症状。胸部计算机断层扫描（CT）显示多个大小不一的肺结节，右下肺叶有一个3.1厘米的胸膜下肿块样密度影，怀疑为转移性疾病。腹部和盆腔CT扫描显示弥漫性转移性疾病，累及肺部、肝脏和腹膜。在超声（US）引导下对肝脏进行了粗针穿刺活检，其形态学和免疫组织化学结果与低分化癌一致。进一步检查后，患者被诊断为促结缔组织增生性小圆细胞肿瘤（DSRCT）。患者接受了8个周期的化疗，但肿瘤转移至远处。随后他接受了两个疗程的盆腔姑息性放射治疗。他的癌症持续进展，最终因病死亡。本病例报告评估了DSRCT姑息性放射治疗的证据、数据、辐射剂量和技术。
