A case of primary histiocytic sarcoma arising from a neck lymph node

Area of Science:

• Hematology
• Oncology
• Surgical Pathology

Background:

• Histiocytic sarcoma (HS) is a rare and aggressive hematological malignancy with poorly established treatment protocols.
• Most patients diagnosed with HS have a poor prognosis, often succumbing within two years.

Purpose of the Study:

• To present a case of histiocytic sarcoma in an elderly patient.
• To discuss the diagnostic and treatment approach for a rare case of HS.
• To highlight the potential for favorable prognosis with local treatment in solitary HS lesions.

Main Methods:

• A case study of an 80-year-old Japanese male with a slow-growing neck mass.
• Diagnostic imaging included ultrasonography, contrast-enhanced CT, MRI, and FDG-PET.
• Fine needle biopsy and histopathological examination confirmed HS diagnosis.
• Surgical resection involved right upper neck dissection and submandibular gland removal.

Main Results:

• The patient presented with a painless, slow-growing mass in the right jaw/neck region.
• Imaging revealed a heterogeneous mass suggestive of malignancy.
• Histopathological analysis confirmed HS, with atypical cells differentiating into histiocytes.
• The patient achieved 2-year survival following surgical resection without adjuvant therapy.

Conclusions:

• Solitary lesions of histiocytic sarcoma may achieve a favorable prognosis with surgical resection.
• Local treatment alone can lead to long-term survival and preserved quality of life in select HS cases.
• This case underscores the importance of considering surgical management for localized histiocytic sarcoma.