The desmoplastic small round cell tumor (DSRCT) has a predilection for
involvement of the peritoneal surfaces of young adult men. The tumor
has an extremely poor prognosis: despite aggressive therapy the patien
ts usually die of disease within the first 2 years following diagnosis
. The present report details the pathologic features of a pelvic tumor
, which proved to be a DSRCT, arising in a previously healthy 24-year-
old man. The light microscopic features were typical of a DSRCT-the tu
mor cells were small and round, had inconspicuous cytoplasm, and were
grouped into distinctive islands and cords that were dispersed in a fi
brous stroma. The immunohistochemical features were likewise character
istic of DSRCT in that the tumor cells were positive for cytokeratin,
vimentin, epithelial membrane antigen, and desmin. Ultrastructurally,
the tumor cells were distinguished by an abundance of intercellular ju
nctions, cytoplasmic lipid droplets, cytoplasmic intermediate filament
s, and an absence of surface microvilli. Recognition of this tumor typ
e is important in view of both its clinical features (extremely poor p
rognosis despite therapy) and its potential to shed some light on the
nature of the family of lesions that has traditionally been classified
by light microscopists as small round cell tumors.