Pigmentations are commonly found in the mouth. They represent in various clinical patterns that can range from just physiologic changes to oral manifestations of systemic diseases and malignancies. Color changes in the oral mucosa can be attributed to the deposition of either endogenous or exogenous pigments as a result of various mucosal diseases. The various pigmentations can be in the form of blue/purple vascular lesions, brown melanotic lesions, brown heme-associated lesions, gray/black pigmentations.

Malignant fibrous histiocytoma (MFH) is widely regarded as the commonest soft tissue sarcoma of adulthood which tends to occur in the deep soft tissues of the extremities and the retroperitoneum. Uncertain histogenesis and numerous subtypes make MFH a rather controversial entity. These tumours are relatively rare in the head and neck region accounting for only 1-3% of all cases of MFH. MFH exhibits a heterogenous histology of spindle cells in a characteristic storiform pattern with pleomorphic tumour cells and giant cells. A case is reported of an MFH of the gingiva in a 60-year-old woman who presented with a painful swelling originating from the left maxillary gingiva. The clinical, histopathological and immunohistochemical findings are discussed.