Cervico-Mediastinal Follicular Dendritic Cell Tumor: A Diagnostic and Therapeutic Challenge

Abstract

Background: Follicular Dendritic Cell (FDC) sarcoma is an extremely uncommon neoplasm with only few cases reported in the literature. The absolute rarity of FDC sarcoma with mediastinal localization has prevented the development of definite guidelines for the treatment of such tumor. Methods and Results:We report the unique case of a 57 year-old-man with a cervico-upper mediastinum extensive (64 × 44 mm) FDC sarcoma, recurred after multiple surgical and chemo-radiotherapeutical treatments, which was removed through anterior cervical approach without sternal-thoracotomy. Conclusion:Immunohistochemistry is essential for FDC tumor differential diagnosis. Basing on its low-intermediate grade of malignancy, a minimally invasive and low-risk treatment, like cervical approach without sternal-thoracotomy, should be considered for the surgical removal of FDC sarcoma massively affecting the upper mediastinum. Figure 1: Axial CT spiral scan showing the enlargement of the left superior mediastinal space and lower neck with a 64 × 44 mm multilobulate mass. Sur g e ry : Cu rrent R e s e ar ch