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Atypical Fibroxanthoma
Lance W Chapman1,2, Siegrid S Yu1,2, Sarah T Arron3,2
1Department of Dermatology, University of California San Francisco, San Francisco, CA.
Seminars in Cutaneous Medicine and Surgery
|May 4, 2019
Summary
Atypical fibroxanthoma (AFX) is a rare skin cancer. Complete surgical excision, particularly Mohs surgery, is the preferred treatment to minimize recurrence risk.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Atypical fibroxanthoma (AFX) is a superficial dermal sarcoma.
- It presents as a nodule or papule, often on sun-damaged skin in the elderly.
- AFX is considered a benign presentation of other pleomorphic dermal sarcomas.
Purpose of the Study:
- To summarize the key characteristics of Atypical fibroxanthoma.
- To highlight diagnostic criteria and treatment options for AFX.
- To discuss the prognosis and recurrence rates of AFX.
Main Methods:
- Review of clinical and histological features of AFX.
- Discussion of diagnostic challenges, including immunohistochemistry.
- Analysis of treatment outcomes, focusing on surgical excision and Mohs micrographic surgery.
Main Results:
- AFX typically appears as a red or pink nodule on the head and neck.
- Histology shows pleomorphic spindle cells in the dermis.
- Diagnosis is often made by exclusion due to non-specific immunohistochemistry.
Conclusions:
- Complete surgical excision, with Mohs surgery as the gold standard, is essential for AFX treatment.
- While metastasis is rare, local recurrence is common, especially in immunosuppressed individuals.
- AFX requires careful management due to its high local recurrence rate.
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