Interdigitating dendritic cell sarcoma of the parotid gland: case report and literature review

Efune, Guy; Sumer, Baran D.; Sarode, Venetia R.; Wang, Huan-You; Myers, Larry L.

doi:10.1016/j.amjoto.2008.05.002

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 4 , Pages 264-268, July 2009

Interdigitating dendritic cell sarcoma of the parotid gland: case report and literature review

Guy Efune, BS
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
Baran D. Sumer, MD
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
Venetia R. Sarode, MD
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Huan-You Wang, MD
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Larry L. Myers, MD
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Corresponding author. Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA. Tel.: +1 214 648 5643; fax: +1 214 648 9122.

Received 22 February 2008 published online 02 October 2008.

Abstract

Interdigitating dendritic cell sarcoma (IDCS) is an exceedingly rare neoplasm arising from the antigen-presenting cells of the immune system. We report a case of IDCS occurring in a 69-year-old man who presented to an outside institution with a painless mass in his right parotid gland for several months. He presented to our institution after undergoing a superficial parotidectomy. A diagnosis of undifferentiated neoplasm, favoring poorly differentiated carcinoma, was made at that time. He underwent a total parotidectomy and neck dissection at our institution. Microscopically, the tumor was composed of atypical spindle cells involving the parotid gland and an ipsilateral level III lymph node. Immunophenotypic analysis demonstrated positive staining for S100, fascin, vimentin, and HLA-II. Follicular dendritic cell, lymphoid, epithelial, myoepithelial, and melanoma markers were negative. Taken together, the above features were consistent with IDCS. An IDCS of the parotid gland is extremely rare, with only 2 cases reported in the literature. The unusual location and morphological similarity to follicular dendritic sarcoma and other types of soft tissue sarcomas can be a diagnostic challenge. Awareness of this tumor and the use of appropriate markers are crucial in making the diagnosis. The patient did well postoperatively, and he underwent a complete course of postoperative irradiation to the right parotid and neck.