ATYPICAL FIBROXANTHOMA: CLINICOPATHOLOGICAL REVIEW
Introduction: Atypical fibroxanthoma (AFX) is a rare cutaneous tumor without a completely defined histogenesis which frequently develops on head and neck of elderly people. Its diagnosis is histological, of exclusion with other tumors with identical morphology. Despite its classical benign behavior some rare cases reporting distant metastasis classified it on intermediate malignancy.
Material and methods: We preformed a retrospective analysis with purpose of reviewing the AFX diagnosis made in our department between 2008 and 2014. We analyzed demographic, clinical, histological and immunohistochemical data and also surgical treatment and recurrence.
Results: We obtained 12 cases of AFX, 11 males and 1 female, the youngest was 25 years old and the others had a median age of 76 years. The lesions were nodules or tumors with 1.9cm median size, all of them located on the head. Histology revealed well defined lesions with atypical pleomorphic cells and frequent solar elastosis, classified as mix variant (spindle and histiocytic cells) in all cases. Immunohistochemical study showed positivity for vimentin and negativity for cytokeratins and S100 protein in all cases and CD10 and CD99 were frequently positive. Surgical excision was performed in 10 cases with 10% rate of recurrence during 3 years of median follow-up.
Conclusions: These results were similar with other published series. This tumor is clinically unspecified and histologically undifferentiated and so immunohistochemistry is essential for diagnosis, however, for now, available makers are not sufficiently specific. Despite its good prognosis in most cases clinical surveillance is recommended.
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