Hystiocytic sarcoma – a case report with the review of treatment

A 45-year old woman presented with pain in her right shoulder and neurologic symptoms in the fingers of her right hand. An extradural tumor mass was diagnosed at the level C6-Th2 and was surgically removed. Pathology report was consistent with histiocytic sarcoma. Additional primary sites on PET-CT involved the right supraclavicular lymph nodes and subcutaneous tissue, liver, uterus and small bowel. After excision, the tumor site was irradiated. When radiotherapy was completed the patient was started on cladribine, however, without success. She was then started on thalidomide, however, the treatment was discontinued because of peripheral neuropathy. One cycle with CHOEP regimen was administered but proved ineffective. She failed an attempt to collect cells for autologous hematopoietic stem-cell transplant. Unfortunately, she was a poor mobilizer. Further on she was treated with interferon, which was not successful either. We proceeded with symptomatic treatment.