A case is reported of malignant fibrous histiocytoma (MFH) of the gingiva. The 65-year-old female presented with a fast-growing mass originating from the left lower gingiva. The tumor measured 15 cm in diameter, occupying the entire oral cavity, protruding outside, and causing a mechanical airway obstruction. It appeared to respond to a 1000 rad single dose of preoperative radiation but recurred soon after composite resection with mandibulectomy, even though surgical margins were reportedly free from microscopic invasion. The patient expired from massive lung metastasis in spite of appreciable local response from treatment. This supports the thesis that MFH is a malignant disease and behaves like any soft-tissue sarcoma, which must be treated aggressively by a combined modality of surgery, radiation, and perhaps chemotherapy.
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