A case of malignant fibrous histiocytoma of the maxillary sinus

High Grade Myxofibrosarcoma of Maxillary Sinus: A Case Report and Review of Literature

Myxofibrosarcoma (MFS) is a soft tissue sarcoma that commonly occurs in late adult life. It is mainly located in the subcutaneous soft tissues of extremities characterized by a high recurrence rate at the original site. MFS of the head and neck is rare, while it occurrence in the maxilla is extremely rare. We report an atypical case of MFS of the maxilla in a 29-year-old male. The tumour was resected with adequate margin and following which post-operative adjuvant radiotherapy was given. This patient has been followed for 2 years to date and has remained disease free. The rarity, the aggressive nature of the pathology, the extent of the tumour and the complex neurovascular structures in close proximity to the site often lead to adverse outcomes. We will be discussing a rare case of a rapidly growing high grade maxillary sinus MFS in a young patient with a history of radiation exposure which posed as a diagnostic challenge. Our case may provide additional diagnostic and treatment experience with regards to managing maxillary sinus myxofibrosarcoma.

Pleomorphic sarcoma of maxillary sinus: Clinical report of a patient initially diagnosed with denture-induced fibrous hyperplasia

Undifferentiated pleomorphic sarcoma is a high-grade soft-tissue malignant tumor that is rare in the head and neck region. A 74-year-old woman displayed a large nodular lesion in the maxillary alveolar mucosa, which was initially identified as denture-related fibrous hyperplasia. Although her prosthodontist has adjusted the maxillary complete denture to relieve pressure on the lesion, it increased in size over time. Computed tomography images of the maxillary sinus showed an extensive destructive lesion. A biopsy was performed, and microscopic examination revealed a poorly differentiated malignancy with numerous spindle cells. Immunohistochemistry reactions were negative for CD45, CD30, CD68, CD34, cytokeratin, S100, desmin, and smooth muscle actin. These findings led to the diagnosis of an undifferentiated pleomorphic sarcoma of the maxillary sinus.

Computed tomography and magnetic resonance imaging findings of malignant fibrous histiocytoma of the head and neck

The aim of this study was to analyze the imaging findings of 15 cases of malignant fibrous histiocytoma (MFH) of the head and neck, in order to better understand the tumor characteristics based on computed tomography (CT) and magnetic resonance imaging (MRI). CT (n=11) and MRI (n=4) images from 15 patients with histologically diagnosed MFH of the head and neck were retrospectively analyzed. The imaging characteristics were analyzed and compared among different histological subtypes. The lesions were primarily located in the maxillary sinus in 5 patients, the ethmoid sinus in 1 patient, the infratemporal fossa in 2 patients, the neck in 4 patients, the left mandible in 1 patient, the gingiva in 1 patient and the epiglottis in 1 patient. A total of 4 cases were associated with radiotherapy. All the lesions were ill-defined, ranging in size from 2.1 to 5.1 cm in the largest diameter. Bone fractures were evident in 9 cases. The attenuation, signal and enhancement patterns varied, although inflammatory MFH exhibited prolonged enhancement in dual-phase enhanced CT scans. MFH of the head and neck is rare but may be associated with radiotherapy. Although the imaging manifestations of MFH are various and non-specific, inflammatory MFH exhibits prolonged enhancement on dual-phase enhanced CT scans.

Malignant fibrous histiocytoma of maxillary sinus- a diagnostic challenge

Malignant fibrous histiocytoma (MFH) is a malignant mesenchymal tumor uncommonly seen in head and neck region and even rarer in maxillary sinus with less than thirty cases reported in literature. Microscopic diagnosis at this rare site may be challenging because of the spectrum of features, which frequently overlap with other benign and malignant tumors. We herein report a case of malignant fibrous histiocytoma of the maxillary sinus in a 40-year-old man who presented with epistaxis. The initial biopsy appeared benign whereas histopathology of wide surgical excision was consistent with MFH. In view of the deep location, the diagnosis may be missed on a small biopsy, which can appear deceptive leading to diagnostic errors. This case report highlights the histopathological difficulties and pitfalls of this tumor at this rare site.

Malignant fibrous histiocytoma/undifferentiated high-grade pleomorphic sarcoma of the maxillary sinus: report of a case and review of the literature

Malignant fibrous histiocytoma (MFH) also known as undifferentiated high-grade pleomorphic sarcoma (UHPS) is a soft tissue sarcoma, composed of undifferentiated mesenchymal tumors possessed fibrohistiocytic morphology without definite true histiocytic differentiation. Head and neck localization is very rare, showing an incidence ranging from 4 % to 10 % in different series of investigations. The most frequent involved sites in UHPS are the neck and parotid, followed by the scalp, face, anterior skull base and orbit. Upper aerodigestive tract, lateral skull base and ear are rare locations. The incidence of the lymphatic metastases is also rare. The aim of this article is to report a case of UHPS in the maxillary sinus with palatal, orbital and ethmoidal involvement, with lymphatic metastasis and its surgical treatment. In addition, we review the literature of similar cases of the past 12 years.

Oral fibrous histiocytoma and its angiomatoid variant

Fibrous histiocytomas are uncommon mesenchymal tumours of the soft tissue in the head and neck region. We report two cases that occurred in the oral cavity, one of a benign fibrous histiocytoma (BFH) and another of an angiomatoid variant of fibrous histiocytoma (AFH). BFH is a benign neoplasm composed of cells with fibroblastic and histiocytic characteristics, while AFH is considered as a distinct type of fibrous histiocytoma with an intermediate malignancy grade that combines features of both fibrohistiocytic and vascular neoplasm. We describe the clinicopathological and histological characteristics of these lesions to clarify and facilitate their diagnosis. In the BFH case, the surgical specimen had many histiocytes positive for lysozime, whereas the AFH cells showed positivity for endothelial cell marker (anti-CD34 antibody). In both cases the tumours were positive for fibronectin and negative for S100 and SMA. Ki-67. Immunohistochemistry was performed in all cases to reveal the different mitotic activity between AFH and BFH tumour cells. Finally, differential diagnoses and therapeutic treatments are discussed.