• Hongli Xu, Bin Chen, Chengwei Jiang, Zhaoying Yang, and Keren Wang.
• Department of Breast Surgery.
• Medicine (Baltimore). 2020 Aug 28; 99 (35): e21935.

RationaleFollicular dendritic cell sarcoma (FDCS) is a rare malignant tumor that originates from germinal center follicular dendritic cells, and can occur at both nodal and extranodal sites. There are very few described cases of FDCS arising in the chest wall.Patient ConcernsA 44-year-old male patient presented with a history of right chest wall pain for 5 months.DiagnosesPositron emission tomography/computed tomography showed a significant increase in F-fluorodeoxyglucose uptake and multiple small axillary lymph nodes without hypermetabolic lesions. Immunohistochemistry results of a core-needle biopsy indicated FDCS, which was consistent with the postoperative pathological examination.InterventionsThe patient underwent tumor resection with lymphadenectomy of level I axillary nodes. No metastasis in the lymph nodes was observed in the postoperative pathological examination. The patient did not accept chemotherapy or radiotherapy.OutcomesAfter 18 months, the patient remains in good condition with no evidence of disease recurrence.LessonsThis report highlights a rare case of a FDCS arising in the chest wall. Accurate clinical diagnosis and staging of this rare malignant sarcoma is essential for the developmnt of effective treatment strategies. Preoperative F-fluorodeoxyglucose positron emission tomography/computed tomography scanning combined with core-needle biopsy could provide differentiation between benign and malignant tumors, as well as lymph node involvement and metastatic status.

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