Background: Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from follicular dendritic cells, with a predilection for extranodal sites. FDCS of the tonsil is exceptionally uncommon, and no standardized treatment exists for patients with locally advanced or inoperable disease, particularly when conventional therapies are contraindicated. Case presentation: We report the case of an 80-year-old woman with localized FDCS of the left palatine tonsil who was ineligible for surgery or systemic therapy due to severe comorbidities. Electrochemotherapy (ECT) with bleomycin was administered under general anesthesia following ESOPE guidelines. The treatment was well tolerated without complications. At two weeks post-treatment, marked tumor reduction and necrosis were observed, and a complete clinical and radiological response was documented at 2 months, and maintained at 12 months of follow-up. Conclusions: To our knowledge, this is the first documented case of tonsillar FDCS treated with ECT. This experience suggests that ECT may represent a valuable local treatment option for selected patients with inoperable FDCS, warranting further investigation of its role in managing rare soft tissue sarcomas.
Complete response of inoperable tonsillar follicular dendritic cell sarcoma treated with electrochemotherapy: First case report and literature review
Guarino, PierreUltimo
2026-01-01
Abstract
Background: Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from follicular dendritic cells, with a predilection for extranodal sites. FDCS of the tonsil is exceptionally uncommon, and no standardized treatment exists for patients with locally advanced or inoperable disease, particularly when conventional therapies are contraindicated. Case presentation: We report the case of an 80-year-old woman with localized FDCS of the left palatine tonsil who was ineligible for surgery or systemic therapy due to severe comorbidities. Electrochemotherapy (ECT) with bleomycin was administered under general anesthesia following ESOPE guidelines. The treatment was well tolerated without complications. At two weeks post-treatment, marked tumor reduction and necrosis were observed, and a complete clinical and radiological response was documented at 2 months, and maintained at 12 months of follow-up. Conclusions: To our knowledge, this is the first documented case of tonsillar FDCS treated with ECT. This experience suggests that ECT may represent a valuable local treatment option for selected patients with inoperable FDCS, warranting further investigation of its role in managing rare soft tissue sarcomas.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
