Journal of Medicine, Radiology, Pathology & Surgery ● Vol. 3:6 ● Nov-Dec 2016 13 Journal of Medicine, Radiology, Pathology & Surgery (2016), 3, 13–15 CASE REPORT Malignant fbrous histiocytoma of mandible: A rare case report Tejavathi Nagaraj, C. K. Sumana, I. Keerthi, Sita Gogula Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India Abstract Malignant fbrous histiocytoma (MFH) is a rare malignant sarcoma of soft tissues of head and neck region. The lesions often arise in the superfcial tissues such as skin and rarely involve deeper tissues. Very few cases of oral involvement of this lesion have been reported till date. Involvement of mandible is only 3%. Clinically, it is difcult to diagnose a MFH if it involves deeper tissues and it is confrmed by histopathological examination. Surgical excision is the treatment of choice. MFH usually has a poor prognosis with a high recurrence rate. We report a case of MFH developed in the left mandible in a 33-year-old male patient. Keywords Fibrous histiocytoma, malignant, surgery Correspondence Dr. C. K. Sumana, Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru - 560 032, Karnataka, India. Phone: +91-9901034300. E-mail: drsumanack83@yahoo.com Received 01 February 2017; Accepted 28 March 2017 doi: 10.15713/ins.jmrps.75 Introduction Fibrous histiocytomas are benign tumors which are composed of cells which can diferentiate into both fbroblasts and histiocytes, rarely it undergoes malignant transformation called as malignant fbrous histiocytoma (MFH). [1] It is an aggressive high-grade sarcoma. MFH was frst reported by O’Brien and Stout in the year 1964. Intraosseous MFH is very rare and was frst described by Feldman and Norman in 1972. [2] Nasal cavity and paranasal sinuses are the most common sites afected in the head and neck region and may involve maxillary bone. Involvement of mandible is very rare accounting for about 2-3% of all bone lesions of MFH. It behaves in a more aggressive fashion in this region than osteosarcoma. [3] Case Report A 33-year-old male patient came with a complaint of swelling on the left side of the face for 10 months [Figure 1]. He gave a history which revealed that the growth started as a small swelling in the posterior tooth region of the lower jaw 10 months back, and since then, it had been gradually increasing to reach the present size causing extraoral swelling in the left side of the face. The swelling was associated with mild pain for 6-7 months. Medical history and family history were non-contributory. Past dental history revealed that the patient had undergone extractions of 36, 37 and 38 6 months back due to mobility. On extraoral examination, a difuse swelling measuring about 6 cm × 4 cm in size was seen on the left side of the lower 3 rd of face involving mandibular ramus, lower border of the mandible, and extending anteriorly about 2 cm away from the angle of the mouth. Skin over the swelling was normal. Swelling was bony hard on palpation, non-tender, and non-compressible. On intraoral examination, a difuse bony hard swelling was present corresponding to extraoral swelling [Figure 2]. The swelling was non-tender with buccal and lingual expansion obliterating buccal sulcus from 35 to 38 region. Mucosa over the swelling was normal, and aspiration was negative. Based on the clinical history, slow growth of the tumor and radiologic fndings provisional diagnosis was given as a benign tumor. Diferential diagnosis includes odontogenic (ameloblastoma, odontogenic myxoma) or non-odontogenic (ossifying fbroma). Panoramic radiograph and cone beam computed tomography images showed well-defned radiolucency in the posterior part of the mandible involving left ramus and body [Figures 3 and 4]. The lower border of ramus was thinned out but did not exhibit any fracture. Hemogram showed blood parameters within normal limits. Histopathologically, proliferating fbroblasts, macrophages, and proliferating spindle cells were observed giving a fnal impression