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

Abstract

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).

Secondary undifferentiated pleomorphic sarcoma of the mandible in a HIV patient who underwent radiotherapy for oral carcinoma

“…6 In 2012, WHO elucidated that diagnosis of UPS could be made only if "no definable line of differentiation" could be established. 4,6 However, the previous term MFH is still widely used by clinicians and pathologists. 4 UPS is more frequent in patients aged between 50 and 70 years with prevalence for males, who account about 65% of cases.…”

“…4,6 However, the previous term MFH is still widely used by clinicians and pathologists. 4 UPS is more frequent in patients aged between 50 and 70 years with prevalence for males, who account about 65% of cases. 12 As reported in literature, the usual clinical presentation is a fast-growing exophytic mass, painless, with or without ulceration and able to expand over a few weeks or months.…”

“…12 As reported in literature, the usual clinical presentation is a fast-growing exophytic mass, painless, with or without ulceration and able to expand over a few weeks or months. 4,12 Most of them appear as primary tumors (70%), while secondary UPS are relatively less frequent and closely associated to preexistent conditions (30%), such as radiation therapy or trauma on the affected area. 1,5 An history of antecedent traumatic event is reported in about 20% of cases suggesting that some of these tumors may represent an initial proliferative response to trauma.…”

“…3 UPS rarely affects the head and neck region and it is even more sporadic in the jaw bones. 4,5 UPS of the head and neck usually appears as a painless and firm growing-mass, which infiltrates the surrounding tissues in the absence of pathognomonic signs and symptoms. 6 When the bone is involved, radiographic features may vary from radiolucency to a mixed radiolucent/radio-opaque appearance.…”

Oral Prevention and Management of Oral Healthcare

“…This may indicate future strategies for preventive measures for hypertensive children and adolescents. Zhurakivska K [ 12 ] focused on malignant fibrous histiocytoma as one of the most common soft tissue sarcomas in adults and found that further studies are necessary in order to standardize the approach to patients affected by oral malignant fibrous histiocytoma.…”