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Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review

  • Authors:
    • Kashif Ali Sarwar
    • Muhammad Sohaib Nadeem
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, Combined Military Hospital/National University of Medical Sciences, Rawalpindi 46000, Pakistan
    Copyright: © Sarwar et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 66
    |
    Published online on: August 26, 2025
       https://doi.org/10.3892/mi.2025.265
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Abstract

Follicular dendritic cell sarcoma (FDCS) is a rare tumour derived from dendritic cells located in B‑follicles that play a pivotal role in the adaptive immune response. Surgery is the mainstay of treatment for localized disease; however, the management of unresectable or advanced disease is less well‑defined. To date, to the best of our knowledge, there is no established or preferred chemotherapeutic regimen, although a number of regimens (primarily used in lymphomas and sarcomas) have been utilized with suboptimal outcomes. The present study describes the case of a young male patient with advanced‑stage unresectable extranodal FDCS that progressed while the patient was undergoing doxorubicin/ifosfamide chemotherapy. Given the limited treatment options available, the patient was subsequently advised to undergo chemotherapy with a combination of gemcitabine/docetaxel. He achieved a marked clinical, as well as radiological response, and an improvement in performance status was also observed. This observation, while having a potential therapeutic bearing, also supports the mesenchymal behaviour of this rare type of tumour. With a number of other recent reports of effective responses to gemcitabine/docetaxel, and an increasing amount of available literature demonstrating its mesenchymal origin, the tumour has been reclassified as ‘stroma‑derived neoplasms of lymphoid tissues’. Consequently, the accumulation of such case reports can help establish a novel first‑line therapeutic regimen for advanced‑stage FDCS.
View Figures

Figure 1

Histopathological analysis with
immunohistochemistry (all images are shown at x400 magnification
with corresponding scale bars at bottom right). (A) Haematoxylin
and eosin staining illustrating a whorled pattern of dendritic
cells with scattered lymphocytes. (B) Staining for CD21
illustrating strong reactivity. (C) Staining for CD23. (D) Weak
staining for leukocyte common antigen (CD45).

Figure 2

Representative slices of
contrast-enhanced computed tomography illustrating tumour [asterisk
symbol (*)] (A) prior to gemcitabine/docetaxel chemotherapy and (B)
following 3 months of chemotherapy. (A) A well-defined, lobulated,
heterogeneously enhancing solid cystic mass lesion can be observed,
measuring 19.2x16.6x14.3 cm (obtained on October 3, 2022). (B) A
marked reduction in the size of same mass to 14x12.4x10 can be
observed (obtained on December 21, 2022). The mass lesion
illustrated by an asterisk (*) is not visible in first image of the
2nd row (LV5-SV1 level). The clear mesentery can be seen marked by
a white triangle. In the other two images, only small cystic masses
can be seen indicating significant reduction of overall tumour size
at these levels (Lower SV1 and SV2, respectively).
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Spandidos Publications style
Sarwar KA and Nadeem MS: Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review. Med Int 5: 66, 2025.
APA
Sarwar, K.A., & Nadeem, M.S. (2025). Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review. Medicine International, 5, 66. https://doi.org/10.3892/mi.2025.265
MLA
Sarwar, K. A., Nadeem, M. S."Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review". Medicine International 5.6 (2025): 66.
Chicago
Sarwar, K. A., Nadeem, M. S."Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review". Medicine International 5, no. 6 (2025): 66. https://doi.org/10.3892/mi.2025.265
Copy and paste a formatted citation
x
Spandidos Publications style
Sarwar KA and Nadeem MS: Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review. Med Int 5: 66, 2025.
APA
Sarwar, K.A., & Nadeem, M.S. (2025). Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review. Medicine International, 5, 66. https://doi.org/10.3892/mi.2025.265
MLA
Sarwar, K. A., Nadeem, M. S."Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review". Medicine International 5.6 (2025): 66.
Chicago
Sarwar, K. A., Nadeem, M. S."Refractory extra nodal follicular dendritic cell sarcoma in a young male exhibiting a marked response to gemcitabine and docetaxel: A case report and literature review". Medicine International 5, no. 6 (2025): 66. https://doi.org/10.3892/mi.2025.265
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