Malignant fibrous histiocytoma - An unusual transformation from benign to malignant

Background: Malignant Fibrous Histiocytoma (MFH) is one of the most common soft tissue sarcoma in adults and typically arises in the soft tissues of the extremities and retroperitoneum. The head and neck region are seldom involved accounting for 3 - 8.5% of the cases. In the superficial sites such as skin, MFH may behave in a benign fashion despite the high grade appearing and fast growing tumor cells, with a reported incidence of malignant transformation around 1%. Case Description: A 72 year old male patient reported to the Department of Oral Medicine & Radiology with a chief complaint of recurrent pain and swelling over the upper lip and nose region which was surgically drained a month back. This was the third occurrence of the swelling over the past 13 years. In the past 2 episodes, he was surgically treated for Benign Fibrous Histiocytoma (BFH). Surgical procedure and histopathological report confirmed malignant transformation into MFH in the recent episode. Conclusion and Clinical Implications: This publication aims to highlight the possibility of malignant transformation of benign fibrous histiocytoma and the importance of long term followup.