Excerpt from Atypical Fibroxanthoma

Synonyms, Key Words, and Related Terms: AFX, sun exposure, photodamage, skin cancer, malignant fibrous histiocytoma, MFH, squamous cell carcinoma, squamous cell cancer, SCC, melanoma, nodular melanoma, sun damage, radiation exposure, radiation damage

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Background

Atypical fibroxanthoma (AFX) is a tumor that occurs primarily in older individuals after the skin of the head and neck has been damaged significantly by sun exposure and/or therapeutic radiation. Clinically, lesions usually are suggestive of malignancy because they arise rapidly (over just a few weeks or months) in skin in which other skin cancers have been found and treated. When this clinical impression is combined with highly anaplastic pathology, misdiagnosis can result in unnecessary and extensive surgery and radiation.

Histologically, lesions show a highly atypical and pleomorphic cellular appearance, but they typically respond to simple excision. Clinicopathologic correlation is essential. Factors important to consider are lesion location, patient age, histopathologic appearance, and the observation that the tumor arises from the dermis, not the fat. Many AFX tumors may represent a superficial form of malignant fibrous histiocytoma (MFH) with a much better prognosis. Some cases may represent primary squamous cell carcinoma (SCC) that fails to express keratin.

Sex

Male-to-female ratio is equal.

Age

In one study, age ranged from 13-95 years with a mean age of 69 years.

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