Follicular Dendritic Cell Sarcoma of the Tonsil: Report of a Rare Case

Abstract

Follicular dendriti c cell tumors are extremely rare. Only 17 cases have been previously described in the literature, and only three ofthem involved prima ry tumors ofthe oral cavity. We describe a new case of the latter, which occurred in a 51-year-old man who sought evaluationfo r a painl ess enlargement of his lef t palatine tonsil. The tonsil was excised, and histologic examination revealed that the tumor was a prima ry sarcoma that had arisen fr om the dendritic reticulum cells of the palatin e tonsil. Postoperatively, the tumor site was treated with percutaneous irradiation (total dose: 70 Gy). Af ter more than 5 years of f ollow-up, the patient showed no evidence of recurrence. We also discuss the salient f eatures of the immunohistochemical examination.

Follicular Dendritic Cell Sarcoma of the Tonsil

“…In cases in which metastasis to regional lymph nodes is suspected on imaging studies, a neck dissection is recommended 3. In the current case, a neck dissection was not performed because no findings suggestive of metastasis to the neck lymph nodes were observed on imaging studies following the diagnostic tonsillectomy.…”

Follicular dendritic cell sarcoma of the tonsil

“…Chan et al [2] consider systemic radiotherapy as the treatment of choice, while other authors such as Perez-Ordonez and Rosai [10,13] prefer this therapy as an option for the treatment of lymph node metastasis of the neck region, positive margins or recurrence of the tumor.…”

“…Then, in 1986, Monda et al reported the first case of primary neoplasm of FDCs in the lymph node [9]. To date, only a few cases of FDC sarcoma in the tonsil have been described [13]. Few extra nodal FDCS were reported by Youens and Waugh [14], and in the pharyngeal or abdominal region [12].…”

Sarcoma de células foliculares dendríticas de la amígdala

“…La extirpación quirúrgica completa es el tratamiento de referencia del FDCS de amígdala 2,6,8,9 ; algunos autores abogan por la disección de cuello en el caso de evidencia de metástasis ganglionar 3 . Se desconoce el beneficio de la radiación o quimioterapia posquirúrgicas para la supervivencia 7 .…”