ULTRA-RARE CANCERSarcomaWHO 5th Edition Classification

Desmoplastic Small Round Cell Tumor (DSRCT)

Ultra-Rare Malignancy (< 1 case per 1,000,000 / year) • Clinical Staging, Genomic Targets & Vetted Specialists

A rare, aggressive soft-tissue sarcoma driven by the EWSR1-WT1 fusion gene. It typically fills the abdominal and pelvic cavity with multiple tumour deposits rather than a single mass, and predominantly affects adolescent and young adult males.

Who It Affects

Adolescents and young adults; strong male predominance (about 4:1)

Annual Incidence

Fewer than 1 per million per year

Clinical Evidence Review

Last audited: 2026-08-13 against NCCN, ESMO, and WHO 5th ed. guidelines.

Clinical Presentation & Hallmark Symptoms

Presenting signs most frequently observed across clinical case series

Abdominal pain and progressive distension
A palpable abdominal mass
Weight loss and fatigue
Constipation or urinary obstruction from pelvic deposits
Ascites

Genomic Profiling & Defining Molecular Lesions

Critical diagnostic fusions, somatic mutations, and therapeutic targets

Rare malignancies frequently depend on distinct oncogenic drivers rather than conventional environmental carcinogens. Comprehensive Next-Generation Sequencing (NGS comprehensive panel) and FISH/IHC are mandatory to establish the true diagnosis and screen for basket trial agents.

EWSR1-WT1 fusion, t(11;22)(p13;q12)

Standard-of-Care Treatment Protocol

Frontline and multimodal strategies established under international consensus guidelines

1

Multi-agent chemotherapy (P6-type regimens with alkylating agents)

Administered in specialized high-volume oncology programs with subspecialty pathology and organ-preservation protocols.

2

Aggressive cytoreductive surgery aiming for near-complete debulking

Administered in specialized high-volume oncology programs with subspecialty pathology and organ-preservation protocols.

3

Hyperthermic intraperitoneal chemotherapy (HIPEC) in selected patients

Administered in specialized high-volume oncology programs with subspecialty pathology and organ-preservation protocols.

4

Whole-abdominopelvic radiotherapy

Administered in specialized high-volume oncology programs with subspecialty pathology and organ-preservation protocols.

5

Clinical trial enrolment

Administered in specialized high-volume oncology programs with subspecialty pathology and organ-preservation protocols.

Clinical Trial Advisory: For rare and ultra-rare malignancies, enrollment in an active clinical trial or expanded-access program is widely considered the preferred standard of care by ASCO and NCCN panels.

Prognosis & Disease Trajectory

Objective clinical outlook without false reassurance

Poor, with five-year survival historically around 15-20%. Patients who achieve greater than 90% cytoreduction alongside systemic therapy have meaningfully longer survival.

Note: Statistics reflect cohort averages. Individual outcomes depend heavily on performance status, resectability, biomarker expression, and timely access to specialized tertiary care.

Active Research, Biomarkers & Clinical Trials

Novel investigational agents, phase I/II trials, and international rare disease consortia

Targeting the EWSR1-WT1 fusion directly, IGF1R inhibition, WT1-directed immunotherapy and vaccine approaches are all under investigation.

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Expert Clinicians

Verified Specialists for Desmoplastic Small Round Cell Tumor

Browse All Oncologists

Dr. Andrea Hayes-Jordan

Pediatric Surgical Oncologist

25+ yrs exp

UNC (formerly MD Anderson)

Chapel Hill, USA

Pediatric Surgical OncologyDSRCTHIPEC
Vetted DirectoryConsult Specialist

Dr. Richard Quek

Senior Consultant Medical Oncologist

16+ yrs exp

NCCS (formerly)

Singapore, Singapore

Sarcoma OncologyDSRCTMultimodal Therapy
Vetted DirectoryConsult Specialist

Prof. Jeremy Whelan

Medical Oncologist

24+ yrs exp

UCLH

London, United Kingdom

Sarcoma OncologyRare Abdominal SarcomasDSRCT
Vetted DirectoryConsult Specialist

Dr. Sameer Rastogi

Sarcoma Medical Oncologist

15+ yrs exp

AIIMS, New Delhi

New Delhi, India

Sarcoma OncologyRare SarcomasDSRCT
Vetted DirectoryConsult Specialist
Hospital Network

Designated Cancer Centers with Dedicated Programs

Search All 72 NCI Centers

NCI-Designated Comprehensive Cancer Center

World-leading rare tumor board & pediatric solid tumor protocols

Proton TherapyCAR-T Cell TherapyRobotic Surgery
1,000+ Active Clinical TrialsView Center Profile

NCI-Designated Comprehensive Cancer Center

Largest specialized rare cancer and sarcoma multidisciplinary program

Proton TherapyCAR-T Cell TherapyCyberKnife SBRT
1,200+ Active Clinical TrialsView Center Profile

NCI-Designated Comprehensive Cancer Center

Pioneering genomic molecular tumor boards & rare histologies

Proton TherapyCAR-T Cell TherapyPhase I Unit
1,100+ Active Clinical TrialsView Center Profile

NCI-Designated Comprehensive Cancer Center

High-volume surgical oncology & rare endocrine/neuroendocrine expertise

Proton TherapyCAR-T Cell TherapyCyberKnife SBRT
600+ Active Clinical TrialsView Center Profile

Frequently Asked Clinical Questions

Authoritative guidance on diagnosis, tumor boards, genomic markers, and care options

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