Oral Fibro-histiocytic Lesions: Immuno-histological Investigation and Review of an Unusual Presentation in the Tongue

A right sided mid-tongue growth in a 14-year-old boy diagnosed initially as Pyogenic Granuloma was found subsequently to be a Benign Fibrous Histiocytoma. This lesion had three seeming recurrences with divergent histologic and clinical appearances within a short period of time. Although there was eventual consensus on the morphogenesis and benign histologic nature of the lesion this caused diagnostic and management problems and a potential prognostic dilemma. This report on a unique and aggressive head and neck lesion, possibly the third documented case in the tongue, reviews the bewildering spectrum of clinical and immunohistologic manifestations of fibrous histiocytic lesions. Wide excision with close follow up is recommended.