Atypical fibroxanthoma

A rare skin tumor typically found in sun-exposed areas of elderly individuals.

Atypical Fibroxanthoma

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Atypical fibroxanthoma on the skin.

Atypical fibroxanthoma (AFX) is a rare, low-grade skin tumor that predominantly occurs in sun-damaged skin of elderly individuals. It is considered a superficial form of pleomorphic dermal sarcoma and is characterized by its atypical spindle-shaped cells.

Clinical Presentation

AFX typically presents as a solitary, rapidly growing nodule or ulcer on sun-exposed areas such as the head and neck. The lesions are usually less than 2 cm in diameter and may appear red, pink, or flesh-colored. Due to its appearance, AFX can be mistaken for other skin conditions such as basal cell carcinoma or squamous cell carcinoma.

Histopathology

Histologically, AFX is characterized by a proliferation of atypical spindle cells with pleomorphic nuclei. The tumor is usually confined to the dermis and does not invade the subcutaneous tissue. Immunohistochemical staining is often used to differentiate AFX from other similar lesions, with markers such as CD10, CD68, and vimentin being positive.

Diagnosis

The diagnosis of atypical fibroxanthoma is primarily based on biopsy and histological examination. It is important to differentiate AFX from more aggressive tumors such as malignant fibrous histiocytoma and melanoma.

Treatment

The standard treatment for AFX is surgical excision with clear margins. Mohs micrographic surgery is often employed to ensure complete removal while preserving healthy tissue. Recurrence is rare if the tumor is completely excised.

Prognosis

AFX generally has an excellent prognosis with a low risk of metastasis. However, regular follow-up is recommended to monitor for any signs of recurrence or new lesions.

Related pages

• Skin cancer
• Dermatology
• Mohs surgery
• Pleomorphic dermal sarcoma