Malignant fibrous histiocytoma of the gingiva

Abstract

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.

Oral Health and Molecular Aspects of Malignant Fibrous Histiocytoma Patients: A Systematic Review of the Literature

“…The 11 considered patients were 5 females and 6 males, with a mean age of 50.8 years, and range between 20 and 82 years. Regarding the site of localization, gums were involved in 4 cases [32,33,36,40]; the tongue was affected in 3 patients, of which 2 cases concerned the lateral surface [19,41]; and the base of the tongue in one case [39]. In one case, the lesion manifested on the oral mucosa [34,35]; another case involved the palate [38] and one the floor of the mouth [43].…”

“…Regarding histotype, 6 cases of histiocytoma presented a storiform-pleomorphic pattern [32,33,40,41,43], one study reported undifferentiated high-grade pleomorphic sarcoma [38], and another one myxoid variant [34] of histiocytoma, while in 3 studies [35,36,39], no specification of histologic subtype was reported. Immunohistochemical positivity for vimentin was reported in 6 studies [32,34,35,38,39,43]; in 5 of these, it was associated with positivity for CD68 [32,34,38,39,43]. Positivity for reticulin was revealed in one study [36], while in another, anti-α 1 -chymothrypsin and α-smooth muscle actin positivity [19] were detected.…”

“…Only 7 of the included studies presented a follow-up period; this was of 17.1 months on average, with a minimum of 3 [36] and a maximum of 28 months [41]. Only one study reported a relapse of the disease 2 weeks after a first surgery consisting of local excision with maxillectomy [38], while 4 studies made no reference to recurrence [32][33][34]40]. These invasive surgeries often require post-surgical rehabilitations [51,52], and in some cases are made complex by the presence of local contraindications (noble anatomical structures [53][54][55][56], or systemic contraindications (general health conditions of the patient [22][23][24]26,57]).…”

“…Thirty-three studies were identified as acceptable for full-text evaluation, and after duplicates were removed, 19 articles were read in full. By the end of this stage, only 11 studies [19,[32][33][34][35][36][37][38][39][40][41][42][43] met inclusion criteria and were included in the qualitative analysis. Eight were excluded [10,[44][45][46][47][48][49][50] because they did not comply with inclusion criteria.…”

Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

“…10 According to literature data, the most common soft tissue sarcoma in the head and neck area is rhabdomyosarcoma, followed by UPS, fibrosarcoma and neurogenic sarcoma. 11 Therefore, recently there are several reports of UPS in buccal mucosa, 12 gingiva, 13 and mandible with pathological fracture, 14 and one case of AFX in the mucosa of the floor of mouth in a patient after squamous cell carcinoma, treated with radiotherapy. 15 The lesion in the last case was superficial with a malignant, histiocytic morphology, thus a diagnosis of AFX to those authors seemed more appropriate than UPS.…”