Clin Exp Otorhinolaryngol.  2014 Mar;7(1):73-75.

Atypical Fibroxanthoma in Head and Neck

• Kim JP
• Ko GH
• Kim JY
• Woo SH

Abstract

Atypical fibroxanthoma is a pleomorphic spindle cell tumor of the dermis and it's been known to be a benign lesion clinically in spite of malignant histologic features. But recurrence is estimated at between 2%-20% and metastasis has been reported. We are about to describe a 70-year-old man with the lesion developed on the left infra-auricular area. The lesion was located superficially and is composed of compact pleomorphic spindle cells and several bizarre multinucleated giant cells. The patient was treated with wide excision. We would like to discuss about this case with a review of literatures.

Keyword

Atypical fibroxanthoma; Biopsy; Excision

MeSH Terms

Aged
Biopsy
Dermis
Giant Cells
Head*
Humans
Neck*
Neoplasm Metastasis
Recurrence

Figure

• 

  Fig. 1 Histopathologic examination demonstrated pronounced atypia, with bizarre, large, hyperchromatic nuclei numerous mitotic figure (H&E, ×200).

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  Fig. 2 Intraoperative photograph shows skin excised state about 3×2 cm-sized included previous incisional scar. There are small portion of parotid gland was seen on the base of resection margin (arrow) (A) Simple sutured after wide excision (B).

Reference

1. Mirza B, Weedon D. Atypical fibroxanthoma: a clinicopathological study of 89 cases. Australas J Dermatol. 2005; 11. 46(4):235–238. PMID: 16197421.

2. Hartel PH, Jackson J, Ducatman BS, Zhang P. CD99 immunoreactivity in atypical fibroxanthoma and pleomorphic malignant fibrous histiocytoma: a useful diagnostic marker. J Cutan Pathol. 2006; 9. 33(Suppl 2):24–28. PMID: 16972949.

3. Krustrup D, Rossen K, Thomsen HK. Procollagen 1 - a marker of fibroblastic and fibrohistiocytic skin tumors. J Cutan Pathol. 2006; 9. 33(9):614–618. PMID: 16965335.

4. Davis JL, Randle HW, Zalla MJ, Roenigk RK, Brodland DG. A comparison of Mohs micrographic surgery and wide excision for the treatment of atypical fibroxanthoma. Dermatol Surg. 1997; 2. 23(2):105–110. PMID: 9107284.

5. Huether MJ, Zitelli JA, Brodland DG. Mohs micrographic surgery for the treatment of spindle cell tumors of the skin. J Am Acad Dermatol. 2001; 4. 44(4):656–659. PMID: 11260542.

6. Chun SI, Park HY, Koh CJ. A case of atypical fibroxanthoma. Korean J Dermatol. 1984; 8. 22(4):454–458.

7. Park HY, Bang DS, Hann SK, Lee SN. A case of cutaneous sarcoidosin in scars. Korean J Dermatol. 1986; 2. 24(1):150–154.

8. Kim YJ, Chung BS, Choi KC. Two cases of atypical fibroxanthoma of the skin. Korean J Dermatol. 1992; 10. 30(5):715–719.

9. Kim HY, Han JH, Ihm CW. A case of atypical fibroxanthoma. Korean J Dermatol. 1993; 12. 31(6):978–982.

10. Jung BC, Woo MJ, Kim SW. A case of atypical fibroxanthoma. Korean J Dermatol. 2001; 9. 39(9):1054–1056.

11. Clover AJ, Athanassopoulos A, Hafeez A, Chakrobarty R, Budny PG. Atypical fibroxanthoma: 10-year experience from a single unit. Eur J Plast Surg. 2008; 6. 31(2):51–54.

12. Giuffrida TJ, Kligora CJ, Goldstein GD. Localized cutaneous metastases from an atypical fibroxanthoma. Dermatol Surg. 2004; 12. 30(12 Pt 2):1561–1564. PMID: 15606841.

13. Sakamoto A, Oda Y, Itakura E, Oshiro Y, Nikaido O, Iwamoto Y, et al. Immunoexpression of ultraviolet photoproducts and p53 mutation analysis in atypical fibroxanthoma and superficial malignant fibrous histiocytoma. Mod Pathol. 2001; 6. 14(6):581–588. PMID: 11406660.

14. Freedberg IM, Eisen AZ, Woff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick's dermatology in general medicine. 6th ed. New York: McGraw-Hill;2003.

15. Weedon D, Williamson R, Mirza B. CD10, a useful marker for atypical fibroxanthomas. Am J Dermatopathol. 2005; 4. 27(2):181. PMID: 15798451.

16. Rizzardi C, Angiero F, Melato M. Atypical fibroxanthoma and malignant fibrous histiocytoma of the skin. Anticancer Res. 2003; Mar-Apr. 23(2C):1847–1851. PMID: 12820468.