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Atypical fibroxanthoma: Clinicopathologic determinants for recurrence and implications for surgical management
Author(s) -
Davidson John S.,
Demsey Daniel
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22128
Subject(s) - medicine , atypical fibroxanthoma , dermis , distant metastasis , presentation (obstetrics) , metastasis , head and neck , dermatology , surgery , pathology , immunohistochemistry , cancer
Abstract Background and Objectives Atypical fibroxanthoma (AFX) is an uncommon skin tumor occurring primarily in the head and neck region of elderly Caucasian males. Treated with local excision, the disease is thought to be fairly benign but can occasionally demonstrate aggressive local recurrence as well as distant metastasis. Methods Seventy‐one cases of AFX were reviewed, representing all patients presenting to the Health Sciences Centre of South Eastern Ontario with the diagnosis of AFX in the period 1989–2008. Demographic and pathologic data were obtained from patient charts for analysis. Results Mean age at presentation was 76, with a male:female ratio of 4:1. Recurrence occurred in 10 patients after an average period of 7.3 months. Three recurrent lesions went on to distant metastasis, on average 14.3 months after initial presentation. The remaining 60 tumors did not recur. Histologically, tumor extending beyond the dermis into the underlying adipose and muscular tissue had a 29.4% chance of local recurrence and an 11.8% chance of metastasis compared to lesions confined to the dermis only (9.3% and 1.8%). Conclusions While the majority of AFX presentations are benign, there is a real possibility of metastatic spread. Invasion beyond the dermis and a rapid rate of recurrence are suggestive of a more aggressive clinical course. J. Surg. Oncol. 2012; 105:559–562. © 2011 Wiley Periodicals, Inc.