Wu Yue, Liu Xianwen, Lv Yingtao, Li Zhiqiang
Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China.
Department of Dental Implantation Prosthodontics, Stomatological Hospital, Southern Medical University, 366 south of Jiangnan Road, Guangzhou 510280, China.
J Stomatol Oral Maxillofac Surg. 2022 Jun;123(3):e106-e111. doi: 10.1016/j.jormas.2021.06.017. Epub 2021 Jul 2.
Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in late adulthood and usually occurs in the limbs, trunk, and peritoneum. Less than 10% of MFH cases occur in the head and neck region. The clinical manifestations and pathological features of MFH are atypical, and it is difficult to make a clinical diagnosis. We describe a rare case of MFH of the floor of mouth and provide our diagnosis and treatment experiences. Through this review, we also evaluate the origin, World Health Organization (WHO) classification, clinical presentations, pathological features, treatment methods, and prognosis of MFH. MFH may originate from fibroblasts or primitive mesenchymal cells. MFH was defined as undifferentiated pleomorphic sarcoma in the 2002 WHO classification of bone and soft tissue tumors. The most common manifestation of MFH is a painless enlarging nodule, often without overlying epidermal ulcers. Jaw lesions are usually found after displays of swelling, pain, paresthesia, and loose teeth. MFH is composed of pleomorphic spindle cells, usually with hemorrhage, necrosis, and lymphocyte infiltration. The main treatment method is surgical resection. Moreover, radiotherapy and chemotherapy have certain auxiliary effects. The local recurrence and distant metastasis of MFH are common, and the prognosis is poor. Therefore, determining the histopathological features of MFH and conducting appropriate immunohistochemical examinations are crucial in establishing the correct diagnosis. In-depth study is required in order to have a better understanding of head and neck MFH.
恶性纤维组织细胞瘤（MFH）是成年晚期最常见的软组织肉瘤，通常发生于四肢、躯干和腹膜。MFH病例中不到10%发生在头颈部区域。MFH的临床表现和病理特征不典型，临床诊断困难。我们描述了1例罕见的口底MFH病例，并分享我们的诊断和治疗经验。通过本综述，我们还评估了MFH的起源、世界卫生组织（WHO）分类、临床表现、病理特征、治疗方法及预后。MFH可能起源于成纤维细胞或原始间充质细胞。在2002年WHO骨与软组织肿瘤分类中，MFH被定义为未分化多形性肉瘤。MFH最常见的表现是无痛性增大的结节，通常无表皮溃疡。颌骨病变通常在出现肿胀、疼痛、感觉异常和牙齿松动后才被发现。MFH由多形性梭形细胞组成，通常伴有出血、坏死和淋巴细胞浸润。主要治疗方法是手术切除。此外，放疗和化疗有一定辅助作用。MFH局部复发和远处转移常见，预后较差。因此，确定MFH的组织病理学特征并进行适当的免疫组化检查对建立正确诊断至关重要。为了更好地了解头颈部MFH，还需要深入研究。
