The Tusks of Mannoroth is one of the rarest transmogs in the game with the drop chance of this item estimated at around 0.1% to 0.3%. It has been made slightly easier with a Siege of Orgrimmar Skip in Patch 10.1.5, but at those drop rates, it'll still take a long time to farm.
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Two new items have been added to the Patch 10.2.7 PTR: Bones of Mannoroth and a Cosmetic version of the Tusks of Mannoroth.