Transformation of a normal cell into a cancerous phenotype is essentially backed by genetic mutations that trigger several oncogenic signaling pathways. These signaling pathways rewire the cellular metabolism to meet the bioenergetic and biomass requirement of proliferating cell, which is different from a quiescent cell. Although the change of metabolism in a cancer cell was observed and studied in the mid-20th century, it was not adequate to explain oncogenesis. Now, equipped with a revolution of oncogenes, we have a genetic basis to explain the transformation. Through several studies, it is clear now that such metabolic alterations not only promote cancer progression but also contribute to the chemoresistance of cancer. Targeting specific enzymes and combinations of enzymes can improve the efficacy of cancer therapy and help to overcome the therapeutic resistance.

Fibrosarcoma is a rare soft tissue tumor of connective tissue origin that includes about 0.05% of all the malignancies in the head and neck region of which almost 23% is seen in the oral cavity. This paper describes a rare case of 4-year-old boy who presented with swelling on the right side of face diagnosed as soft tissue fibrosarcoma of the intraoral region. The histopathological and immunohistochemistry confirmed the diagnosis by the presence of spindle-shaped cells arranged in fascicles with mitotic figures and cellular proliferation reproducing fibroblasts. The patient was successfully treated with combination of chemotherapy and surgery with a good clinical outcome. This case report is presented to highlight the rarity of fibrosarcoma in orofacial region of children which requires special attention of pediatric dentist and should be considered as differential diagnose of soft tissue mass in orofacial region of children. Clinical and histopathological features must be correlated with immunohistochemistry in the final diagnosis in fibrosarcoma.

Abstract:Background: Ewing's sarcoma (ES) is a malignancy primarily affecting bone tissue that is commonly diagnosed in adolescents and young adults. Its occurrence in the head and neck region is unusual and generally involves the mandible and maxilla. Radiographic finding in ES reflect many destructive nature of the lesion, like osteolysis, cortical erosion and soft tissue mass. Case report: We report a rare case of ES of the maxilla in a 10-year-old boy with clinical, radiological, histopathological and immunohistochemical findings. Early detection of such lesions is difficult because the signs and the symptoms do not appear until the lesion has progressed considerably. Conclusion:This case explicates the importance of professional knowledge of the relevant aspects of malignant lesions such as Ewing's sarcoma.