# Radiologically Occult Desmoplastic Small Round Cell Tumor in a 36-Year-Old Man: A Case Report

## TL;DR

A 36-year-old man was diagnosed with a rare aggressive tumor after initial tests missed it, showing the need for repeat imaging and early diagnosis.

## Contribution

This case report presents an unusual DSRCT case in an older adult, emphasizing diagnostic challenges and management strategies.

## Key findings

- Initial imaging failed to detect DSRCT in a 36-year-old man with non-specific symptoms.
- Repeat imaging and histopathological analysis confirmed the tumor a year later.
- The case underscores the importance of advanced imaging and early tissue diagnosis for timely management.

## Abstract

Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive mesenchymal malignancy that typically affects adolescents and young adults. We report an unusual case of a 36-year-old man who presented with persistent left flank pain. Initial investigations, including colonoscopy and abdominal computed tomography, were unremarkable. One year later, repeat imaging revealed a large intra-abdominal mass associated with liver metastases. Histopathological examination and immunohistochemical analysis confirmed the diagnosis of DSRCT. This case highlights the diagnostic challenges of DSRCT, particularly when it occurs outside the usual age range and presents with non-specific symptoms. Persistent or unexplained symptoms should prompt repeat and advanced imaging, as well as early tissue diagnosis, to facilitate timely multidisciplinary management.