Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2019; 7(6): 785-791
Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.785
Primary hepatic follicular dendritic cell sarcoma: A case report
Hui-Min Chen, Ya-Li Shen, Ming Liu
Hui-Min Chen, Ya-Li Shen, Ming Liu, Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen HM collected the data and contributed to manuscript drafting; Shen YL and Liu M guided the treatment and revised the manuscript; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81572850.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ming Liu, PhD, Professor, Department of Medical Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China.
Telephone: +86-28-85164045 Fax: +86-28-85423203
Received: November 28, 2018
Peer-review started: November 28, 2018
First decision: January 19, 2019
Revised: February 3, 2019
Accepted: February 26, 2019
Article in press: February 26, 2019
Published online: March 26, 2019

Follicular dendritic cell sarcoma (FDCS) is an uncommon type of tumor with low incidence. To date, no standard treatment for the disease has been established. Surgery remains the main treatment. Adjuvant chemotherapy and radiotherapy are optional approaches. Metastatic cases require multidisciplinary collaborative treatments. However, the choice of chemotherapeutic drugs is controversial.


A 66-year-old Chinese woman presented to our hospital complaining of intermittent pain of right upper quadrant. An enhanced computed tomography (CT) scan of the abdomen revealed hepatocellular carcinoma. Subsequently, the patient underwent a radical partial hepatectomy. Primary FDCS of the liver was diagnosed pathologically. Except for regular follow-up examinations, the patient did not receive adjuvant chemotherapy or radiotherapy. However, fluorine-18-fluorodeoxyglucose positron emission tomography/CT (PET/CT) confirmed lymph node metastases in the space of ligamentum hepatogastricum and pancreatic head, as well as the portacaval space. The patient was given systemic chemotherapy with gemcitabine and docetaxel for she was unsuitable for surgery. Satisfactorily, the metastatic lymph nodes were significantly reduced to clinical complete remission after eight cycles of chemotherapy. Then, strengthened radiotherapy was followed when the patient rejected the opportunity of surgery. Eventually, the carcinoma got better control and the patient was free of progression.


This case highlights the importance of making suitable chemotherapy regimens for the rare tumor. The combination of gemcitabine, docetaxel, and consolidated radiotherapy may offer a new promising option for the treatment of metastatic hepatic FDCS in the future.

Keywords: Follicular dendritic cell sarcoma, Liver, Chemotherapy, Gemcitabine, Docetaxel, Radiotherapy, Case report

Core tip: This case report is important because it provides a potential strategy for hepatic follicular dendritic cell sarcoma, which is a rare tumor with no standard treatment to date. The choice of chemotherapeutic drugs is currently controversial. Main systemic chemotherapy drugs focus on those applied on lymphoma and soft tissue sarcoma, but the efficacy is variable. In our case, cytotoxic drugs such as gemcitabine and docetaxel play an important role in antitumor therapy. The role of follow-up radical radiotherapy should not be ignored.