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Giornale Italiano di Dermatologia e Venereologia 2007 June;142(3):277-83

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Atypical fibroxanthoma: the role of pre-existing neoplasia and acquired immunodeficiency. A series of 9 cases

Wollina U. 1, Güther S. 1, Köstler E. 1, Schönlebe J. 2, Ziemer M. 3, Koch A. 1, Schreiber G. 3, Haroske G. 2

1 Department of Dermatology and Allergology Dresden-Friedrichstadt Hospital Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany 2 Institute of Pathology “Georg Schmorl” Dresden-Friedrichstadt Hospital Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany 3 Department of Dermatology and Dermatological Allergology, Medical School Friedrich-Schiller-University of Jena, Jena, Germany


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Atypical fibroxanthoma (AFX) is a rare mesenchymal tumour of skin. We report on a series of 8 male patients and 1 female patient aged 68 to 90 years. All tumours were localized in the head and neck region. Six patients had a cancer history, 1 had a renal transplant and 1 suffered from systemic sarcoidosis. Medical history was positive for radiotherapy or chemotherapy in 4 patients. Histology showed a mostly spindle shaped dermal and subcutaneous tumour growth intermingled with multinucleated giant cells. The phenotype of tumour cells was vimentin positive but S100 and keratin negative. Some tumours showed a focal expression of CD68. Complete surgical excision controlled microhistographically (“Mohs like”) was possible in all cases followed by mesh-graft transplantation in 3 patients. Six patients showed a complete remission but 1 had a local relapse followed by regional metastasis was seen in 1 patient. Undefined lymph node enlargements of the chest were seen in another one. It is suggested that a medical history of neoplasia and/or immunosuppression/immunodeficiency might be a risk factor for AFX in elderly people. We recommend a follow-up of 5 years after diagnosis of AFX in analogy to non melanoma skin cancer since the tumour can show local relapse or develop metastatic spread.

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