Atypical Fibroxanthoma of the Brow Arch of the Face in a Female

Atypical fibroxanthoma (AFX) is an uncommon dermal neoplasm that predominantly affects sun-exposed head and neck skin in older adults. It is locally aggressive and can resemble other cutaneous malignancies, requiring histopathologic and immunohistochemical confirmation and careful surgical management, with Mohs micrographic surgery reducing recurrence compared with wide local excision.

An 81-year-old woman presented with an elevated skin lesion on the right side of her face in the eyebrow arch. The lesion presented as a peanut-sized red nodule that grew over a 6-month period with breakthrough bleeding and crusting. The excised specimen was ultimately diagnosed as atypical fibroxanthoma. This study reports a rare case of atypical fibroxanthoma of the face in a female.

This case expands the clinicopathologic spectrum of atypical fibroxanthoma by documenting a rare lesion of the eyebrow arch in an elderly woman, underscores the importance of rigorous histopathologic and immunohistochemical assessment to secure the diagnosis and exclude mimics, and shows that complete surgical excision can achieve short‑term remission; continued surveillance is warranted given the risk of local recurrence, and further reports are needed to refine site‑specific management and outcomes.