Histiocytic sarcoma of the base of tongue treated with radical radiotherapy: A case report and review of the literature.

Published on Jan 22, 2020in Clinical and Translational Radiation Oncology
· DOI :10.1016/J.CTRO.2020.01.002
Zsuzsanna Iyizoba-Ebozue2
Estimated H-index: 2
Cathy Burton8
Estimated H-index: 8
(St James's University Hospital),
Robin Prestwich28
Estimated H-index: 28
Abstract Histiocytic sarcoma (HS) is an exceedingly rare and aggressive neoplasm of lymphoid and haematopoietic tissues and expresses histological and phenotypical characteristics of mature histiocytes. There have only been a few cases of documented HS in the head and neck region. Whilst patients with HS often have nodal or disseminated disease, patients can present with localised disease. There are currently no established treatment guidelines, and reported cases of localised disease have been managed with primary surgery and adjuvant radiotherapy and/or chemotherapy. Here we present, the case of a 49 year old man with a HS of the base of tongue treated with radical radiotherapy to a dose of 60Gy in 30 fractions, achieving disease free survival of greater than 5 years with minimal toxicity. To our knowledge, this is the first reported case of HS treated with radical radiotherapy, and suggests that when the potential morbidity of surgery for localised disease is significant, radiotherapy may represent an alternative treatment.
#1Vignesh Shanmugam (Harvard University)H-Index: 7
#2Gabriel K. Griffin (Harvard University)H-Index: 19
Last. Jason L. Hornick (Harvard University)H-Index: 96
view all 6 authors...
Recent studies have demonstrated recurrent activating mutations involving the classical MAPK and PI3K signaling pathways in a large proportion of histiocytic neoplasms, such as Langerhans cell histiocytosis. However, very little is known about the molecular genetics of histiocytic sarcoma, a rare aggressive malignant neoplasm that shows pathologic characteristics of mature macrophages. Here we report the genomic characteristics of a large cohort of histiocytic sarcomas (n = 28) using a targeted ...
26 CitationsSource
#1Giuseppe Barbato (University of Modena and Reggio Emilia)H-Index: 1
#2Alessandro Tarantini (University of Modena and Reggio Emilia)H-Index: 1
Last. Roberta Gelmini (University of Modena and Reggio Emilia)H-Index: 12
view all 8 authors...
Abstract Introduction Histiocytic sarcoma (HS) is a very rare malignant histiocytic derivation cancer. The extranodal multisystemic HS has an aggressive clinical course and poor Disease-Free Survival (DFS) and Overall Survival (OS). There are no shared and effective therapeutic protocols; our approach aims to improve the prognosis for advanced diseases. Presentation of the case 53-year-old female patient admitted to hospital for intestinal obstruction in April 2016 with evidence of an ileal mass...
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#1Jian Zhou (CSU: Central South University)H-Index: 140
#2Yue Liu (SDU: Shandong University)H-Index: 1
Last. Feng-Lei Xu (SDU: Shandong University)H-Index: 1
view all 4 authors...
: Histiocytic sarcoma (HS) is a term used to describe malignant hyperplasia of cells exhibiting morphological and immunophenotypical characteristics similar to those of mature cells, with expression of one or more tissue cell markers, excluding acute monocytic leukemia and primitive monocytic sarcoma. We herein describe a case of histiocytic sarcoma of the neck supported by histopathological and immunohistological evidence. A 53-year-old female patient of Chinese descent presented with a rapidly...
2 CitationsSource
#1Anuhya Kommalapati (USC: University of South Carolina)H-Index: 10
#2Sri Harsha Tella (USC: University of South Carolina)H-Index: 16
Last. Gaurav Goyal (Mayo Clinic)H-Index: 13
view all 5 authors...
TO THE EDITOR: Histiocytic sarcoma (HS) is a rare hematopoietic neoplasm derived from non-Langerhans histiocytic cells of the monocyte/macrophage system that is diagnosed using immunohistochemistry markers, such as CD68, lysozyme, CD4, and CD163, on the tissue biopsies.[1][1] HS can occur in
27 CitationsSource
#1Steven H. Swerdlow (University of Pittsburgh)H-Index: 64
#2Elias Campo (University of Barcelona)H-Index: 150
Last. Elaine S. JaffeH-Index: 181
view all 11 authors...
A revision of the nearly 8-year-old World Health Organization classification of the lymphoid neoplasms and the accompanying monograph is being published. It reflects a consensus among hematopathologists, geneticists, and clinicians regarding both updates to current entities as well as the addition of a limited number of new provisional entities. The revision clarifies the diagnosis and management of lesions at the very early stages of lymphomagenesis, refines the diagnostic criteria for some ent...
2,902 CitationsSource
#1Mrinal M. Gounder (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 25
#2Ved Desai (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 2
Last. William D. Tap (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 53
view all 19 authors...
Background Neoplasms of histiocytic and dendritic cell origin, including follicular dendritic cell sarcoma (FDCS), histiocytic sarcoma (HS) and interdigitating dendritic cell sarcoma (IDCS), are extremely rare, and data on their natural history and treatment outcomes are sparse. We evaluated the impact of surgery, radiation and systemic therapies on overall survival (OS).
40 CitationsSource
#1Winnie Wu (UCLA: University of California, Los Angeles)H-Index: 3
#2Asli Tanrivermis Sayit (UCLA: University of California, Los Angeles)H-Index: 1
Last. Jonathan W. Said (UCLA: University of California, Los Angeles)H-Index: 93
view all 6 authors...
Summary Histiocytic sarcoma (HS) is a rare neoplasm that occurs most commonly in the intestinal tract, skin, soft tissue, and lymph node. The incidence of primary central nervous system (CNS) HS is even rarer, with a total of 6 cases reported in the literature. An etiologic link has not been identified for CNS HS, and the current case of primary CNS HS is unique in that an etiologic link to prior radiation therapy is identified, associated with complex cytogenetic abnormalities in the tumor. Alt...
23 CitationsSource
#1Emiko Takahashi (Aichi Medical University)H-Index: 12
#2Shigeo Nakamura (Nagoya University)H-Index: 101
Histiocytic sarcoma (HS) is an extremely rare malignant neoplasm showing morphologic and immunophenotypic evidence of histiocytic differentiation. The vast majority of previously reported HSs are now generally recognized to be misdiagnosed examples of non-Hodgkin lymphomas, predominantly diffuse large B-cell lymphoma or anaplastic large cell lymphoma. The recognition ofsuch tumors parallels the development and widespread use ofimmunohistochemical techniques, along with the development ofmolecula...
93 CitationsSource
#1Filip Yves Francine Léon De Vos (EUR: Erasmus University Rotterdam)H-Index: 2
#2Martin N. GerdingH-Index: 1
Last. Jurgen J. WegmanH-Index: 1
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Dear Editor, “Histiocytic sarcoma” is a rare haematological neoplasm with immunohistochemical and morphological diagnostic criteria per exclusionem. In this case report, our patient illustrates that this rare tumour with its unique location and diagnostic morphologic criteria is sensitive to a combination of anthracycline-based chemotherapy and radiotherapy, resulting in complete response for 2 years. A 64-year-old Caucasian woman presented with an asymptomatic, gradually enlarging neck mass at ...
9 CitationsSource
#1Ming Cao (Cornell University)H-Index: 2
#2Camellia Eshoa (St Mary's Hospital)H-Index: 11
Last. Chung Che Chang (Cornell University)H-Index: 1
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Abstract Histiocytic sarcoma is a rare, malignant neoplasm of the lymphohematopoietic system that usually occurs in the skin, lymph node, and intestinal tract. Here we describe a unique case of primary central nervous system histiocytic sarcoma that initially showed an indolent clinical course following local resection and radiotherapy. However, relapse of disease within the mediastinum was noted 3½ years later. Biopsies of the initial brain lesion and subsequent mediastinal recurrence each reve...
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