The Uncommon Mandibular Malignancy: A Case Of Fibrosarcoma with Favorable Surgical Outcome

Keywords:  Fibrosarcoma, Mandible, Spindle Cell Sarcoma, Rare Case, Histopathology

Introduction: Primary malignant tumors of the mandible are rare, and among them, fibrosarcoma constitutes a very small subset. It is a high-grade spindle cell sarcoma with aggressive behavior and a tendency for local recurrence. Early detection and wide excision with histopathological margin clearance are vital for disease control. This report discusses an unusual presentation of mandibular fibrosarcoma in a 27-year-old male who underwent segmental mandibulectomy with supraomohyoid neck dissection. Grossly, a 2.6 cm firm, grey-white infiltrative mass was noted in the mandible. Microscopically, the tumor showed spindle-shaped malignant cells arranged in interlacing fascicles and herringbone pattern. Brisk mitoses, nuclear pleomorphism, and focal necrosis were seen. All surgical margins were free from tumor, and no lymphovascular or perineural invasion was identified. Nine lymph nodes from levels I–III were isolated, all negative for tumor. Final diagnosis: High-grade fibrosarcoma (FNLCC Grade 3); pathological stage pT1N0Mx (AJCC 8th Edition). This case underscores the importance of early surgical intervention with clear margins and lymph node dissection, supported by histopathology and IHC, in improving outcomes in rare mandibular malignancies.

Digital Formats:  Any image file format that can be imported into this file will be acceptable for publication; to avoid technical problems, we suggest using PNG/JPEG format and mention Fig number with short detail.

Fig 1: Contrast-enhanced CT scan (axial view) showing an expansile lytic lesion involving the left mandibular body with cortical erosion and heterogeneous enhancement, suggestive of a malignant intraosseous tumor.

Fig 2: Gross specimen of left segmental mandibulectomy showing a firm, grey-white intraosseous tumor with cortical thinning and two teeth in situ. Tumor measured 2.6 × 1.6 × 2.4 cm.

Fig 3&4: Microscopy (H&E, 10×, 40 x) shows spindle-shaped malignant cells in interlacing fascicles and herringbone pattern with pleomorphism, brisk mitosis, and necrosis—consistent with high-grade fibrosarcoma (FNLCC Grade 3).

Biography: Dr. Saumya Tiwari is an Associate Professor in the Department of Pathology at Heritage Institute of Medical Sciences, Varanasi. Graduate from Lady Hardinge Medical College New Delhi and Post graduate from Maulana Azad Medical College. With over a decade of experience in diagnostic pathology and medical education, she specializes in Oncopathology, soft tissue tumors, and hematolymphoid malignancies. Dr. Tiwari is known for her keen diagnostic acumen and her contribution to student mentorship, case-based learning, and research in rare tumors. She has authored several publications in national and international journals and regularly presents cases at academic conferences. Apart from her academic pursuits, she is actively involved in organizing interdisciplinary workshops and has a strong

References: 

1. Abu El-Naaj I, Leiser Y, Peled M, Laufer D. Fibrosarcoma of the mandible: literature review and case report. J Oral Maxillofac Surg. 2005;63(5):725–728. doi:10.1016/j.joms.2004.10.020
2. Bertoni F, Unni KK, Beabout JW, Ebersold MJ. Fibrosarcoma of the jaw bones: a review of 25 cases. Cancer. 1986;57(6):1224–1232. doi:10.1002/1097-0142(19860315)57:6<1224::AID-CNCR2820570623>3.0.CO;2-M
3. Dewan RK, Varshney D, Arora P, Rastogi V. Fibrosarcoma of the mandible: a rare case report and review of literature. J Oral Maxillofac Pathol. 2017;21(1):145. doi:10.4103/jomfp.JOMFP_73_15 interest in integrating clinicopathological correlations into undergraduate training. She believes in the power of early diagnosis, interdepartmental collaboration, and ongoing learning to improve patient care.
   

#UCJournals #Fibrosarcoma #MandibularCancer #OralOncology #HeadAndNeckSurgery #RareTumors #MaxillofacialSurgery #OncologyResearch #CancerCaseReport #OralPathology #TumorResection #OralCancerAwareness #SarcomaResearch #ClinicalOncology #SurgicalOncology #PathologyResearch #MedicalCaseStudy #OralHealthResearch #RareCancerAwareness #Histopathology #HeadNeckOncology #CancerTreatment #CancerResearchCommunity #FibrosarcomaAwareness #OralMaxillofacialPathology #OncologicalSurgery #RareCancerResearch #JournalPublication #CancerManagement #OncologyUpdates #SurgicalCaseReports #OralSurgeryCases #MedicalResearch #CancerSurvivorship #OncologyEducation #FibrosarcomaResearch #HeadNeckCancerCare #ClinicalMedicine #CaseReportsInOncology #PathologyUpdates #RareOncologyCases #CancerTherapies #OralMedicine #HealthcareResearch #CancerDiagnostics #CancerAwarenessMonth #HeadAndNeckPathology #OncologyCommunity #FibrosarcomaTreatment #MedicalPublication