Journal of Experimental & Clinical Cancer Research 2008, 27:33 http://www.jeccr.com/content/27/1/33 are the most widely used markers, demonstrating follicu- lar dendritic cells differentiation and should help in their recognition [2,6-9]. FDC sarcoma was considered an indolent tumor with low tendency of recurrence or metastasis; but recent larger reports with longer follow up have showed that FDC sar- coma is more aggressive tumor and should be considered an intermediate-grade malignancy. Chan et al. have reported that at least 40% of documented FDC sarcomas have recurred and 25% have metastasized with a mortality rate of 16.7% [2,10]. Because this significant recurrent and metastatic potential it is reasonable that resected localized disease may be pre- vented from recurrence by adjuvant radiotherapy or chemotherapy [11-13]. In our case report, the patient underwent surgical excision and postoperatively was given five cycles of COP plus Cae- lyx, utilizing cyclophosphamide, vincritine, prednisone and pegylated liposomal doxorubicin. PEG liposomal doxorubicin is an alternative preparation of doxorubicin, which has been shown to have reduced cardiotoxicity and is characterized by a very long circula- tion half-life, favorable pharmacokinetic behaviour and specific accumulation tumor tissues [14,15]. PEG lipo- somal doxorubicin has already shown activity in soft-tis- sue sarcoma, head and neck cancer, multiple myeloma, aggressive non-Hodgkin's lymphoma. Based on these encouraging experiences and in considera- tion of the higher response rate, shorter time to response and less toxicity obtained with PEG liposomal doxoru- bicin also in the treatment of AIDS-related Kaposi's sar- coma [16], compared with conventional doxorubicin, we decided to treat our patient with COP plus Caelyx regi- men, even if she had no particular cardiac risk. No hema- tological or cardiac toxicity was registered and among the other extra hematological effects only palmar erythrodys- esthesia was worthy of mention. The patient is alive and event free at 5 years after diagnosis. In the literature treatment modality of FDC sarcoma var- ied widely although surgical resection was often included. With a median follow up of 18 months, about 40% of the cases recurred and the 5 years recurrence-free survival was 27.4%, further the role of chemotherapy and radiotherapy in the treatment of this neoplasm is not yet clearly defined [2,10]. Clinical findings, histology and immunopheno- type of our case appear to be typical of FDC sarcoma but the complete resection achieved by surgery and the use of adjuvant COP plus PEG liposomal doxorubicin, regimen ever reported to our knowledge to treat this tumor, and the very good response at 5 years of follow-up show some issues of interest. A longer follow-up and further studies are warranted to determine whether this combination treatment may be useful in the management of FDC sarcoma, at least in localized nodal disease, once it is identified and well char- acterized by the appropriate application of immunohisto- chemical staining. References 1. Monda L, Warnke R, Rosai J: A primary lymph node malignancy with features suggestive of dendritic reticulum cell differen- tiation. A report of 4 cases. Am J Pathol 1986, 122:562-72. 2. 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