title: Radiation-induced undifferentiated high-grade pleomorphic sarcoma (malignant fibrous histiocytoma) of the mandible: report of a case arising in the background of long-standing osteomyelitis with a review of the literature.
abstract: We report a rare case of radiation-induced undifferentiated high-grade pleomorphic sarcoma (UPS) (malignant fibrous histiocytoma, MFH) in the right mandible of a 44-year-old woman. The patient had suffered from osteomyelitis of the same region of the mandible for several years, which was considered to be due to radiotherapy for a malignant lymphoma in her right neck 19 years before. The tumor appeared as an exophytic and invasive growth in the molar region of the mandible. Histopathologically, the tumor consisted of an interlacing proliferation of vimentin-immunopositive spindle-shaped fibroblastic cells with bizarre nuclei with high Ki-67 labeling scores, and tumor cells showed storiform patterns mixed with pleomorphic cells. Taking the history of radiation into consideration, we diagnosed the lesion as radiation-induced MFH/UPS. Including the present case, there have been only 14 documented cases of radiation-induced UPS in the jawbone, and this is the first UPS case arising in the follow-up period of long-standing osteomyelitis.
authors.affiliation: Division of Oral and Maxillofacial Surgery, Oral and Maxillofacial Radiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Division of Oral and Maxillofacial Surgery, Oral and Maxillofacial Radiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, and Resident, Division of Oral Pathology, Niigata, Japan. Electronic address: maru@dent.niigata-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, and Resident, Division of Oral Pathology, Niigata, Japan; Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Abé
authors.affiliation: Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Wael Mohamed
authors.initials: WM
authors.lastname: Swelam
authors.affiliation: Division of Oral and Maxillofacial Surgery, Oral and Maxillofacial Radiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Yasumitu
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Oral Implant Clinic, Niigata University Hospital, Niigata, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hoshina
authors.affiliation: Division of Oral and Maxillofacial Surgery, Oral and Maxillofacial Radiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Ritsuo
authors.initials: R
authors.lastname: Takagi
authors.affiliation: Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, and Resident, Division of Oral Pathology, Niigata, Japan; Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Saku
mesh_terms: D000328:Adult; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008334:Mandible / Q000473:pathology*; D060787:Neoplasm Grading; D009381:Neoplasms, Radiation-Induced / Q000473:pathology*; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D011878:Radiotherapy / Q000009:adverse effects
keywords: Malignant fibrous histiocytoma; Malignant lymphoma; Mandible; Osteomyelitis; Radiation-induced