Atypical fibroxanthoma: new insights

Abstract

Atypical fibroxanthoma (AFX) is an ultraviolet radiation-associated dermal neoplasm. To address the clinicopathologic and molecular features of this particular neoplasm. The author conducted a literature review using PubMed searching for articles relating to AFX. AFX usually appears as a rapidly growing nodular or nodulo-ulcerative lesion. It occurs on sun-exposed skin of elderly peoples. AFX may be composed predominantly of pleomorphic, spindle, epithelioid cells, or admixture of these cells. The differential diagnosis of AFX includes pleomorphic dermal sarcoma, squamous cell carcinoma, malignant melanoma and leiomyosarcoma. Several observations favor a mesenchymal origin for AFX. These reviews address the clinicopathologic features, molecular pathology, prognosis and treatment of this neoplasm.

Incidence rate and clinicopathological features of 62 atypical fibroxanthomas in a North‐Western Spanish population

“…AFX typically presents as a rapidly growing light‐brown, red or pink papule, nodule or nodule‐ulcerative lesion (Fig. ), which is usually less than 2 cm in diameter . Although we usually perform dermatoscopy on solitary tumours, this technique is not considered useful as a diagnostic tool in this neoplasm due to the lack of specific structures.…”

“…2), which is usually less than 2 cm in diameter. 11 Although we usually perform dermatoscopy on solitary tumours, this technique is not considered useful as a diagnostic tool in this neoplasm due to the lack of specific structures. Red and white structureless areas and linear irregular vessels are the most common dermatoscopic features in a recently published study including 40 AFXs.…”

Atypical fibroxanthoma management: Recurrence, metastasis and disease‐specific death

“…There is debate in the literature as to whether deeper tumours should be labelled UPS. Although many have been proposed, there are currently no specific stains or specific diagnostic criteria to reliably and consistently identify AFX . Hence the diagnosis of AFX in the papers included in this study were dependent on the expertise and techniques utilised at individual institutions.…”

An Unusual Case of Pinna Squamous Cell Carcinoma Arising Shortly after Resection of Atypical Fibroxanthoma

“…Another factor to be considered is the possibility of metachronous (consecutive) development of AFX and SCC at the same site. This is plausible since UV radiation is known to be the major causative factor for cutaneous SCC, and both clinical and molecular data suggest that UV radiation is also a triggering factor for AFX [ 4 ].…”

“…AFX classically presents as a solitary ulcerated nodule on the sun-damaged areas of the head and neck of elderly adults. The pathological differential diagnosis includes pleomorphic dermal sarcoma, spindle cell squamous cell carcinoma, malignant melanoma, and leiomyosarcoma [ 4 ].…”