Atypical fibroxanthoma

Synonym(s)

Paradoxical fibrosarcoma; pseudosarcoma; pseudosarcomatous reticulohistiocytoma; pseudosarcomatous dermatofibroma

Definition

Rapidly enlarging tumor, arising in chronically sun-exposed skin, with histologic features suggesting a malignant connective tissue neoplasm, but usually benign clinical course

Pathogenesis

Solar radiation and prior X-irradiation possible predisposing factors

Clinical manifestation

Firm, solitary, eroded or ulcerated papule or nodule on sun-exposed skin, particularly the ear, nose, and cheek; most common in elderly patients

Atypical mole syndrome 71

Differential diagnosis

Squamous cell carcinoma; pyogenic granuloma; melanoma; basal cell carcinoma; Merkel cell carcinoma; cutaneous metastasis; leiomyosarcoma; dermatofibrosarcoma protuberans

Therapy

Mohs micrographic surgery*; elliptical excision; destruction by electrodesiccation and curettage

References

Davis JL, Randle HW, Zalla MJ, Roenigk RK, Brodland DG (1997) A comparison of Mohs micrographic surgery and wide excision for the treatment of atypical fibroxanthoma. Dermatologic Surgery 23(2)1105-110

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