Atypical Fibroxanthoma

Key Points
Skin tumor usually appearing on the head or neck of elderly patients
Consists of a red, dome-shaped nodule which may be ulcerated or crusted
Single or multiple tumors may occur
Generally appear in areas which are vulnerable to excessive exposure to the sun

Atypical Fibroxanthoma is a skin tumor which affects the head and neck of elderly patients. It begins as a small nodule, which can quickly grow to a tumor of 2-3 cm. The tumor is dome-shaped, and may be ulcerated or crusted and appear red in color. It can occur singly or in multiples. While it may behave as a benign lesion, it should be considered cancerous.

Development Atypical Fibroxanthoma is often associated with excessive exposure to sun or radiation treatments that have caused damage to the skin, which cause abnormal growth of tumor cells in spindle cells of the dermis. It most often occurs in the elderly. In rare cases, it can affect younger persons or parts of the body not normally exposed to sunlight, appearing on the trunk or extremities. These tumors tend to be larger and grow more slowly than the more prevalent form of the condition.

Differential Diagnosis (Other conditions with similar appearance)

Spindle cell squamous cell carcinoma
Malignant melanoma
Leiomyosarcoma
Malignant fibrous histiocytoma

Diagnosis
Key Points
Diagnosis based on biopsy of affected tissue

Atypical fibroxanthoma generally appears to be much like other skin cancers, so its specific diagnosis can only be accomplished by a biopsy of the tumor, or testing it after removal.

Treatment
Treatment involves removing the tumor by various means
Many removal techniques can be used, depending on the size of the tumor
Avoiding sun exposure is key to prevention

Atypical Fibroxanthoma, like other skin cancers, are treated by removing the tumor. Smaller tumors may be removed by curettage. In the case of larger tumors or tumors which recur, a procedure called Mohs Micrographic surgery is used to remove the entire tumor while not damaging surrounding healthy tissue.

It is recommended for those persons that wish to prevent the development of Atypical fibroxanthoma, in addition to other types of skin cancer, avoid excessive exposure to the sun. Affected persons are advised to avoid further sun exposure with conventional sun protection methods, such as use of sunscreen and protective clothing.