Abstract
Atypical fibroxanthoma (AFX) is an uncommon neoplasm that typically involves sun-damaged areas of the head and neck; it is seen most frequently in elderly white men. UV radiation has been found to cause DNA damage in dermal fibroblasts and has been associated with the development of AFX. AFX typically presents as a rapidly growing, red, often ulcerated nodule on the ear, face, or scalp. AFX can resemble several other neoplasms, both clinically and histologically. Therefore, histologic examination, along with use of immunohistochemical stains, is essential in the diagnosis of AFX. Once a diagnosis of AFX is made, the treatment of choice is complete surgical removal. Treatment with Mohs micrographic surgery (MMS) has been found to be superior to treatment with wide local excision (WLE). MMS has the advantages of allowing for tissue conservation, which is especially important on the head and neck, and of achieving total microscopic margin control. Local recurrence, metastasis to regional lymph nodes, and distant metastasis have been reported; therefore, regular, long-term follow-up is recommended for at least the first 2 years after diagnosis of AFX.
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Abbreviations
- AFX:
-
Atypical fibroxanthoma
- MFH:
-
Malignant fibrous histiocytoma
- MMS:
-
Mohs micrographic surgery
- WLE:
-
Wide local excision
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Knudson, R.M., Cook-Norris, R.H., Youse, J.S., Roenigk, R.K. (2012). Atypical Fibroxanthoma. In: Nouri, K. (eds) Mohs Micrographic Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-2152-7_21
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