Radiographic evaluation of malignant fibrous histiocytoma affecting maxillary alveolar bone: a report of 2 cases

Undifferentiated pleomorphic sarcoma of the mandible

Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindle-cell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.

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.

Rare sarcoma presented as sinusitis

Myxofibrosarcoma (MFS) also known as myxoid variant of malignant fibrous histocytoma is one of the most common soft tissue sarcomas of the extremities in adult and elderly patients with rare occurrences in head and neck region. Low-grade MFS is unusual among low-grade sarcomas because it often recurs relentlessly and multiplies despite wide local resection with gross negative margins. We report a case of extreme rarity and a tumour of aggressive nature in the maxillary sinus, which presented with non-specific sinonasal symptoms and we present a review of the radiological and histopathological characteristics of this rare tumour and recent evidence of management.

Malignant fibrous histiocytoma of the mandible

We report a case of malignant fibrous histiocytoma (MFH) primary within the mandible of a 32-year-old female. The mandible is a rare location of MFH, accounting for only 3% of all tumours of this type occurring within bone. The clinical, pathological and radiographic features are discussed with special emphasis on the radiographic features of this lesion.

Intramandibular inflammatory myofibroblastic tumor--a true neoplasm or reactive lesion?

OBJECTIVE

Inflammatory myofibroblastic tumor (IMT) is an uncommon lesion reported to arise in various organs and by convention believed to be a nonneoplastic reactive inflammatory condition. Because of its radiographic and histologic similarities to malignancy, IMT can pose a considerable diagnostic dilemma. The purpose of this study is to report the first intramandibular IMT and to discuss the possible nature of this lesion.

STUDY DESIGN

Detailed documentation of clinical, radiographic, and histologic features; literature review.

RESULTS

This lesion showed distinct radiographic, histologic, and immunohistochemical features. The lesion recurred 14 months after initial removal with almost identical histology.

CONCLUSION

This is the first documented case of an intramandibular IMT. Due to the rarity of these lesions, their clinical sequelae and prognosis are undetermined. As a result of specific immunohistochemical phenotyping and clinical behavior of this lesion, we favored a diagnosis of inflammatory myofibroblastic tumor. Wide excision with a long-term clinical follow-up is required.