Atypical fibroxanthoma

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Atypical fibroxanthomas are well-circumscribed mesenchymal skin tumors that mainly manifest in the head and neck

Epidemiology

Atypical fibroxanthomas are rapidly growing tumors associated with excessive sun exposure, i.e. UV exposure, and usually occur in elderly patients. There is also an association with immunosuppression, including post-transplant and AIDS. Rarely, it occurs in younger patients at other locations including the trunk and without a history of excessive sun exposure. Men are more frequently affected.

Pathology

Atypical fibroxanthomas are fibrohistiocytic skin tumors with a wide range of appearances on histological examinations and a certain histological similarity to squamous cell carcinoma. The diagnosis requires skin biopsy with careful evaluation to differentiate it from other skin tumors,

Radiographic features

Atypical fibroxanthomas might be detected as a nodular skin lesion of some millimeters up to some centimeters on ultrasound, CT or MRI. After administration of a contrast agent, it has been described to show enhancement.

Treatment and prognosis

Atypical fibroxanthomas are surgically removed and have a good prognosis. They might locally reoccur with the necessity of re-surgery. Metastatic spread has been only rarely described.

Differential diagnosis

  • other skin tumors