Follicular Dendritic Cell Sarcoma of the Head and Neck: Case Report and Literature Review

Recurrent Follicular Dendritic Cell Sarcoma of the Parotid Gland Imaged with 18F-FDG PET/CT

Follicular dendritic cell sarcoma (FDCS) is an extremely rare tumor with only 67 cases of head and neck FDCS reported in the literature. A 65-year-old female had a 6-cm follicular dendritic cell sarcoma resected from the left parotid gland with close margins. It recurred 1 year later as a 5-cm mass that was intensely [18F] fluoro-2-deoxy-D-glucose (18F-FDG) avid on positron emission tomography/computed tomography (PET/CT) and was re-excised. A follow-up PET/CT did not show any metastatic disease. The use of 18F-FDG PET/CT in the management of FDCS warrants further research. We present the 18F-FDG PET/CT imaging findings of this rare tumor.

Follicular dendritic cell sarcoma of the spleen: A case report and review of the literature

Follicular dendritic cell sarcoma (FDCS), which originates in antigen-presenting cells of the B-cell follicles of the lymph nodes, is an uncommon disease, particularly in a splenic location. In a number of cases, FDCS may easily be confused with other solid tumors and be underdiagnosed. The present study reports a case in which such as tumor occurred in a 64-year-old woman. The patient presented with an abdominal mass, and computed tomography was performed. Histological and immunohistochemical studies revealed a diagnosis of FDCS. The patient underwent surgical treatment and had a good remission. At the time of writing, the patient was in good condition. The present study also discusses the clinical characteristics, treatment methods and prognosis of FDCS, with particular reference to the main points of the imaging diagnosis.

Follicular dendritic cell sarcoma of the head and neck: Case report, literature review, and pooled analysis of 97 cases

BACKGROUND

Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm presenting in the head and neck. There are no pooled analyses of head and neck FDCS cases in the English language literature.

METHODS

A MEDLINE and PubMed review of cases from 1978 to February 2014 was performed. Demographics, clinicopathologic data, and outcomes were summarized.

RESULTS

We presented 2 patients and analyzed 97 cases. The mean age was 42.7 years (SD = 16.3 years). Outcomes were available for 76 patients. Tumors ≤4 cm had better disease-free survival (63% vs 28% at 5 years; p = .0282). Locoregional recurrence was significantly less likely with surgery and radiation compared to surgery alone (15% vs 45%; p = .019) and in patients receiving a neck dissection (10% vs 43%; p = .046).

CONCLUSION

This pooled analysis provides the largest sample size of FDCS of the head and neck to date and suggests that radiation and neck dissection may be beneficial to locoregional oncologic control. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2241-E2249, 2016.

Intraperitoneal follicular dendritic cell sarcoma: role of chemotherapy and bone marrow allotransplantation in locally advanced disease?

We describe a case of a 44 year-old woman diagnosed with follicular dendritic cell sarcoma (FDCS). FDCS is a very rare disease affecting the dendritic antigen presenting cells and is often misdiagnosed. Surgery is considered the best treatment modality, followed by chemotherapy. In our case, surgical excision was not possible, therefore the patient received two lines of chemotherapy followed by bone marrow allotransplantation, then a third line of chemotherapy with a complete metabolic response seen on PET/computed tomography (CT) follow-up 29 months later. A review of the literature has been performed.

Pediatric follicular dendritic cell sarcoma of the head and neck: a case report and review of the literature

OBJECTIVE

Follicular dendritic cell sarcoma is a rare disease with a non-specific and insidious presentation that is further complicated by difficult diagnostic and therapeutic assessment.

METHODS

The database PubMed was searched for reports of follicular dendritic cell sarcoma between 1986 (first case published) and 2012. All of the articles presenting informations regarding one or more cases of follicular dendritic cell sarcoma of the head and neck region, in patients less than 18 years of age, were included. The reference lists for pertinent reports were also scanned to ensure that all relevant literature was included.

RESULTS

We present a case of a 14 year-old girl, with a 2-month history of a right-sided level II neck mass. After a carefull radiologic evaluation the mass was resected combined with a right selective neck dissection. Histology with immunohistochemical staining was positive for follicular dendritic cell sarcoma. No recurrence was seen after 31 months follow-up. The literature search identified six more cases of pediatric follicular dendritic cell sarcoma of the head and neck. This is the first female patient with follicular dendritic cell sarcoma in the pediatric population.

CONCLUSIONS

Current treatment of head and neck follicular dendritic cell sarcoma consists of wide radical resection, with associated radiotherapy or chemotherapy only for cases with aggressive disease such as extracapsular invasion, tumor size ≥6 cm or after failure of the first-line surgical treatment.

Dendritic cell sarcoma: a pooled analysis including 462 cases with presentation of our case series

Dendritic cell tumors are extremely rare and current knowledge on these tumors is limited. The characteristics of three dendritic cell sarcoma subtypes and their optimal treatment approaches are not fully clarified. We aimed to make a systematic review of the literature and enrich the current data with five new cases. Pooled analysis of 462 reported cases revealed that the tumor had no age, gender or racial predilection. Our analysis suggests that the young age, advanced stage, intraabdominal involvement and unfavorable histological features (i.e. large tumor size, absence of lymphoplasmacytic infiltration, coagulative necrosis, high mitotic count) may predict poor prognosis. Subtypes of this tumor have different clinical behaviors with interdigitating dendritic cell sarcoma being the most aggressive form. In general, surgery is the most effective treatment modality and adjuvant radiotherapy has no significant effect on overall survival of patients. The role of chemotherapy for the management of advanced disease is controversial.

Follicular dendritic cell sarcoma of the pharyngeal region

Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising most commonly from follicular dendritic cells in the lymph nodes. It is exceedingly rare in extranodal sites, particularly in the pharyngeal region. The present study reports 3 cases occurring in the pharyngeal region. Case 1 had tonsil and cervical lymph node involvement, while case 3 also had tonsil involvement. Cases 1 and 3 relapsed locally at 3 and 17 months after surgery, respectively. Case 2 was diagnosed with a tumor in the parapharyngeal space and the patient succumbed to the disease 5 months after treatment with combined surgery and chemotherapy. All 3 cases were misdiagnosed initially. Pathological biopsy examination, including histopathology and immunohistochemistry, was essential for diagnosis. The data for 52 cases, including cases from the literature and the present cases, were analyzed. The results indicated that 57% (26/46) of the initial diagnoses were inaccurate, while the recurrence, metastasis and mortality rates were 40, 16 and 10%, respectively. The statistics supported the theory that FDCS of the pharyngeal region is a low-grade sarcoma. Involvement of the tonsils (52%, 27/52) and parapharyngeal space (19%, 10/52) were observed most commonly, while FDCS at various sites showed different prognoses. The various survival rates were calculated in the present study. The large tumors (≥4 cm) had a poorer prognosis than the small tumors (<4 cm; P<0.05). Among the 50 cases with available follow-up data, 46% (23/50) were treated with surgery alone, 52% (26/50) with combination therapy (surgery followed by chemotherapy and/or radiotherapy) and 2% (1/50) with surveillance. There was no statistically significant evidence (P>0.05) that combination therapy improves survival rates, compared with surgery alone.

Dendritic cell tumor in a salivary gland lymph node: a rare differential diagnosis of salivary gland neoplasms

Dendritic cell tumors are extremely rare neoplasms arising from antigen-presenting cells of the immune system. We report a case of a 69-year-old man with an unremarkable medical history who presented with a 2-months history of a gradually enlarging painless, firm, mobile, 2 × 2-cm swelling at the caudal pole of the left parotid gland without systemic symptoms. Histologically, the tumor consisted of a spindle cell proliferation in an intraparotideal lymph node. Based on the histopathologic, immunohistochemical and electron microscopic findings, a dendritic cell tumor, not otherwise specified (NOS) in an intraparotideal lymph node was diagnosed.

The patient underwent complete tumor resection, and is currently free of disease, 2 years after surgery. These extremely rare tumors must be distinguished from other more common tumors in the salivary glands. Awareness that dendritic cell tumors may occur in this localization, careful histologic evaluation and ancillary immunohistochemical and electron microscopical analyses should allow for recognition of this entity.

Follicular Dendritic Cell Sarcoma of the Neck: Case Report and Review of Current Diagnostic and Management Strategies

Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm that can clinically mimic a number of other tumors. FDCS can follow either an indolent or aggressive course. The prognosis tends to be worse for patients with large or high-grade tumors and/or an intra-abdominal tumor site. For optimal management, complete surgical excision is recommended. Radiation therapy and/or chemotherapy may be considered for incompletely resected tumors and for tumors with poor prognostic features, but the exact role of adjuvant therapy is unknown. We report a case of cervical FDCS in a 39-year-old black man, and we review the presentation and management of this disorder, with emphasis on the differential diagnosis.