YO10 - Rectal Follicular Dendritic Cell Sarcoma

Case summary

A 22y/female

No comorbidities

No family history of any malignancy

Presented with complaints of mass P/R from December 2014

Initially patient was on alternative medication with an opinion of hemorrhoids

In October 2015 in view of increased symptoms got evaluated and U/W Sigmoidoscopy and found to have growth

2/12/15 U/W Polypectomy

HPR S/O Follicular dendritic cell sarcoma with negative margins

21/12/15 CECT S/O no abnormality , though patient was planned for surgery with revision of margins opted for observation

July 2016 Patient is asymptomatic and on follow up found to have (USG and CT further) multiple liver metastases with Bx consistent with same.

Received 4# CHOP till 17/11/16

Dec 2016 CT S.O Increase in number and size of hepatic metastases

Started on Gemcitabine+Docetaxel 6# with interim assessment S.O partial response and further mainatined.

11/9/17 U.W RFA of Segment VIII of right lobe and Segment III of left lobe of liver.

Received 2# more Gemciatbine+Docetaxel till 20/10/17

November 2017 PET CT S/O Complete metabolic response and kept on observation

9/3/18 Evaluated for abdominal discomfort and S.O liver lesions in segment IVb and Segment V lesions

15/3/18 IVb and V lesion coiling was done and kept on observation

May 2018 Significant increase in number and size of lesions and was started on Tab.Capecitabine 500mg BD+Tab.Sorafenib 400mg BD

July 2018 Response assessment was done S/O increase in size of lesions with maximum lesion size increased from 3.9----->6 cms

Started on Tab.Pazopanib +Tamoxifen

October 2018 response assessment was done S/O Partial response with decrease in size and enhancement

27/12/18 U/W resection of liver IVb/V segments and Pazopanib+Tamoxifen were continued as an adjuvant from January 2019 to April 2019

Lost to follow up for 2 months and stopped medications from 2 months

13/6/19 Asymptomatic but CT S/O two new lesions in liver segment VII 2.1x 1.4cms and 1.2x1.2 cms were noted.

CURRENT STATUS : Restarted on Tab.Pazopanib 400mg BD and planned for RFA further

Clinical trial identification

Editorial acknowledgement