Atypical fibroxanthomas are well-circumscribed mesenchymal skin tumors that mainly manifest in the head and neck
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Epidemiology
Atypical fibroxanthomas are rapidly growing tumors associated with excessive sun exposure, i.e. UV exposure, and usually occur in elderly patients. There is also an association with immunosuppression, including post-transplant and AIDS. Rarely, it occurs in younger patients at other locations including the trunk and without a history of excessive sun exposure. Men are more frequently affected.
Pathology
Atypical fibroxanthomas are fibrohistiocytic skin tumors with a wide range of appearances on histological examinations and a certain histological similarity to squamous cell carcinoma. The diagnosis requires skin biopsy with careful evaluation to differentiate it from other skin tumors,
Radiographic features
Atypical fibroxanthomas might be detected as a nodular skin lesion of some millimeters up to some centimeters on ultrasound, CT or MRI. After administration of a contrast agent, it has been described to show enhancement.
Treatment and prognosis
Atypical fibroxanthomas are surgically removed and have a good prognosis. They might locally reoccur with the necessity of re-surgery. Metastatic spread has been only rarely described.
Differential diagnosis
- other skin tumors