Malignant fibrous histiocytoma of the tongue

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

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in adults. It occurs only occasionally in oral soft tissues, and knowledge about its characteristics is based on a limited number of cases reported in the literature. Malignant fibrous histiocytoma belongs to the group of soft tissue sarcomas and makes up less than 10% of soft tissue sarcomas. For therapeutic purposes, complete exeresis of the lesion (macroscopic and microscopic) is performed because they have frequent recurrences. As for complementary therapy in addition to surgery, neither radiotherapy nor chemotherapy have been shown to reduce the risk of death related to the disease. Often patients complain of a swelling that grows in a short period of time. It is quite common for patients to report trauma in the area, which is not the cause, but rather the event that allows diagnosis. The mass usually does not cause pain unless it compresses an adjacent nerve structure. The aim of this study is to systematically review the scientific literature in order to identify the most recent studies concerning malignant fibrous histiocytomas localized in oral soft tissues and report their main data. The main outcomes of this study concern the immunohistochemical, molecular, and clinical aspects of this pathology. A systematic review of articles in the electronic databases pubmed, Scopus, and Web of Science was performed. After the selection process, 11 studies met the inclusion criteria and were included in the review. The mean age of the patients was 50.8 years old. The lesions affected various parts of the oral cavity, showing predominantly storiform-pleomorphic patterns. All cases except one were treated with surgical resection and radiation therapy. Although some data emerged from this review, they remain limited to a few case reports. Further studies are necessary in order to standardize the approach to patients affected by oral malignant fibrous histiocytoma (MFH).

Clinical Features and Treatment of Fibrous Histiocytomas of the Tongue: A Systematic Review

Introduction  Benign fibrous histiocytomas are common lesions of the skin that rarely affect the tongue. Such cases are available in the literature exclusively as case reports. Similarly, malignant fibrous histiocytoma, now classified as undifferentiated pleomorphic sarcoma, is exceedingly rare in the tongue and not fully understood. Objectives  This study systematically reviews the available literature discussing the clinical and pathological features of malignant and benign fibrous histiocytomas. Data Synthesis  A total of 20 cases were included in this review. Patient-level data were extracted from cases to include clinical presentation, workup, treatment, and outcome. Conclusion  Benign fibrous histiocytomas are consistent in clinical and histopathologic presentation. Surgical treatment provides excellent outcome, with no recurrence in all excised cases. Malignant tumors have a more aggressive clinical and pathological presentation. Surgical treatment with possible adjuvant radiotherapy resulted in recurrence in 40% of cases (follow-up of 24 months), and death due to disease in 47% of patients (follow-up of 19 months).

A rare case of malignant fibrous histiocytoma of the gingiva

BACKGROUND

Malignant fibrous histiocytoma (MFH) is an aggressive, high-grade tumor with poor prognosis. It is the most common soft tissue sarcoma in adults, usually occurring retroperitoneally in extremities. MFH of the head and neck is rare. Cases with primary involvement of only the oral soft tissues have been reported; a few occurred in the gingiva. Its clinical features include a painless enlarging mass, which may or may not be ulcerated.

METHODS

A 20-year-old female patient presented with a non-healing necrotic ulceration of 4 months' duration on the maxillary anterior labial gingiva. Based on her history and agricultural background, a provisional diagnosis of chronic fungal and chronic bacterial infection was given. The patient was placed on a topical antifungal in combination with antibiotic therapy for 10 days. Because the lesion failed to respond to the initial therapy, an incisional biopsy was performed. The lesion was diagnosed as MFH based on clinical, histopathologic, and immunohistochemical findings.

RESULTS

The patient was referred to the Department of Oncology and Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, for further evaluation and treatment; the lesion was treated by resection of the premaxilla, and a splint was placed. She was followed up for 3 months with improvement in her condition.

CONCLUSIONS

Because MFH is rare in the oral cavity, misdiagnosis may not be unusual based on the initial clinical examination. Any suspicious lesion that is unresponsive to treatment must be subjected to histopathologic evaluation to arrive at a final diagnosis.