Metastasizing atypical fibroxanthoma. Coexistence with chronic lymphocytic leukemia

Atypical fibroxanthoma (AFX) is one of a group of cutaneous lesions with a malignant histological appearance but a generally benign clinical course. A 79-year-old white man had AFX of the cheek that recurred and metastasized to buccal and cervical lymph nodes three months after initial diagnosis. When careful physical and and laboratory examinations were done, the patient was found to have concomitant chronic lymphatic leukemia, "null cell" type. In view of the low incidence of metastasizing AFX and the increased occurrence of tumors in patients with lymphomatous disorders, an important association is suggested. Before establishing the prognosis for patients with pseudomalignancies of the skin, an evaluation of their general health and immunological status should be made.