title: Management of a rapidly enlarging new adnexal mass: a rare case of desmoplastic small round cell tumor of the ovary arising in pregnancy.
abstract: BACKGROUND
  Desmoplastic small round cell tumor (DSRCT) is an extremely rare sarcomatous tumor, which is most commonly seen in men. Clinicians managing a patient with a rapidly enlarging mass in pregnancy should be aware of the risk for malignancy.
  
  
  METHODS
  A 31-year-old woman was found to have a newly enlarged ovarian mass in the second trimester. She subsequently underwent a laparotomy for removal, with chemotherapy for presumed poorly differentiated ovarian malignancy. Ultimately she was diagnosed with a desmoplastic small round cell tumor of the ovary and had progression at time of delivery. Following cesarean delivery, she had a tumor reductive surgery. She has completed 12 cycles of intensive chemotherapy and is alive with disease at 14 months.
  
  
  CONCLUSIONS
  Care should be taken not to delay evaluation of a rapidly enlarging mass in pregnancy. While this tumor type is extremely rare, a malignancy in pregnancy must be ruled out in this clinical scenario.
authors.affiliation: The Ohio State University Wexner Medical Center, Division of Gynecologic Oncology, 320 W. 10th Avenue, M210 Starling Loving Hall, Columbus, OH 43210, United States.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Neff
authors.affiliation: The Ohio State University Wexner Medical Center, Division of Maternal Fetal Medicine, 395 W. 12th Avenue, 5th Floor, Columbus, OH 43210, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Kellert
authors.affiliation: Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, United States.
authors.forename: Michelle
authors.initials: M
authors.lastname: Isley
authors.affiliation: The Ohio State University Wexner Medical Center, Division of Gynecologic Oncology, 320 W. 10th Avenue, M210 Starling Loving Hall, Columbus, OH 43210, United States.
authors.forename: Floor
authors.initials: F
authors.lastname: Backes
keywords: Chemotherapy; Ovary; Pregnancy; Sarcoma