PDF(Pubmed)
Abstract：
We present a case of follicular dendritic cell sarcoma in the axillary lymph node, which unexpectedly showed favorable outcomes after the application of apatinib. Follicular Dendritic Cell Sarcoma (FDCS) exhibits a rare incidence and an unclear pathogenic mechanism, contributing to the limited breakthroughs in its treatment to date within the medical field. The current mainstream therapeutic approaches include surgery, CHOP(cyclophosphamide, doxorubicin, vincristine, prednisone), ICE(ifosfamide, carboplatin, etoposide), ABVD(doxorubicin, bleomycin, vinblastine, dacarbazine), and immune checkpoint inhibitors. A 38-year-old male patient was admitted to the hospital due to a lump in the right axilla and underwent surgical treatment. Postoperative pathology confirmed the diagnosis of follicular dendritic cell sarcoma. Two months post-surgery, he faced a recurrence, prompting a subsequent surgical intervention complemented by tumor radiofrequency ablation. Despite these interventions, the treatment response was suboptimal. Subsequently, the patient was treated with the CHOP regimen, but after two cycles, he developed bone metastasis. Due to the patient\'s limited financial resources and refusal of immunotherapy, we switched to a regimen of gemcitabine and docetaxel, but the disease progressed again after two cycles. A one-cycle trial of albumin-bound paclitaxel yielded unsatisfactory results. Ultimately, the patient was treated with Apatinib, achieving a 10-month progression-free survival. Due to the patient\'s limited financial circumstances, we, in the absence of guideline recommendations and evidence from evidence-based medicine, achieved a 10-month progression-free survival (PFS) solely based on experiential use of the anti-angiogenic drug, Apatinib. The purpose of this case report is to provide additional therapeutic options for FDCS treatment and to pave the way for exploring the mechanism of action of Apatinib in FDCS.
摘要：
我们介绍了一例腋窝淋巴结滤泡树突状细胞肉瘤，在应用阿帕替尼后，意外地显示出有利的结果。滤泡树突状细胞肉瘤（FDCS）表现出罕见的发病率和不清楚的致病机制，迄今为止，在医疗领域对其治疗的有限突破做出了贡献。目前主流的治疗方法包括手术，CHOP（环磷酰胺，阿霉素,长春新碱,泼尼松)，ICE(异环磷酰胺，卡铂,依托泊苷)，ABVD（阿霉素，博来霉素,长春碱,达卡巴嗪)，和免疫检查点抑制剂。一名38岁的男性患者因右腋下肿块入院，并接受了手术治疗。术后病理诊断为滤泡树突状细胞肉瘤。手术后两个月,他面临复发，促使随后的手术干预辅以肿瘤射频消融。尽管有这些干预措施,治疗反应欠佳。随后，患者接受CHOP方案治疗，但是在两个周期之后，他发生了骨转移.由于患者的财力有限和拒绝免疫治疗,我们改用吉西他滨和多西他赛的治疗方案，但是疾病在两个周期后再次进展。白蛋白结合的紫杉醇的一个周期试验产生了不令人满意的结果。最终,患者接受了阿帕替尼治疗，实现10个月无进展生存期。由于病人的经济状况有限,我们,在缺乏指南建议和循证医学证据的情况下，仅基于抗血管生成药物的经验使用，实现了10个月的无进展生存期（PFS），阿帕替尼。本病例报告的目的是为FDCS治疗提供更多的治疗选择，并为探索阿帕替尼在FDCS中的作用机制铺平道路。
