Atypical Fibroxanthoma: A case series and review of literature

Mahalingam, Sridhayan; Shah, Aadarsh; Stewart, Ann

doi:10.1016/j.anl.2015.04.001

Cited by 19 publications

(14 citation statements)

References 19 publications

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“…Other modes of treatment reported, included brachytherapy and radiotherapy, curettage and cautery, and cryotherapy …”

Section: Resultsmentioning

confidence: 99%

“…Surgical margins recommended by authors have varied significantly depending on the experience at their institution. Suggested management strategies include advocating for clear margins, for 5‐mm, 6‐mm, 10‐mm and for up to 20‐mm margins after tumour clearance. There did not appear to be a benefit from any reported safety margin so long as there was microscopic margin clearance.…”

Section: Discussionmentioning

confidence: 99%

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Atypical fibroxanthoma management: Recurrence, metastasis and disease‐specific death

2017

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Atypical fibroxanthoma (AFX) is a rare spindle cell neoplasm predominantly found on the head and neck of elderly individuals with sun-damaged skin, with no evidence-based guidelines for their management. A systematic retrospective review of the literature focusing on treatment modality found a recurrence and metastasis rate of 8.0% (5.6% when adjusted for incomplete excisions) and 0.5% for local excision and 4.6% and 3.2% for Mohs micrographic surgery, respectively. Our results suggest that with clear surgical margins, AFX is unlikely to recur and metastases are rare, with significantly higher rates in the immunosuppressed population.

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“…Other modes of treatment reported, included brachytherapy and radiotherapy, curettage and cautery, and cryotherapy …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Atypical fibroxanthoma management: Recurrence, metastasis and disease‐specific death

2017

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“…Our work also shows that AFX is rarely suspected in clinical practice as is the case for Merkel cell carcinoma. 15 Squamous cell carcinoma is the main clinical diagnosis made by clinicians, 16,17 which is not surprising since this tumour arises in sun-exposed areas in patients with chronic actinic damage.…”

Section: Discussionmentioning

confidence: 99%

Incidence rate and clinicopathological features of 62 atypical fibroxanthomas in a North‐Western Spanish population

et al. 2019

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Background/Objectives Atypical fibroxanthoma (AFX) is a mesenchymal neoplasm of unknown incidence. It has been determined that AFX is a tumour with low aggressiveness as long as it is properly diagnosed. Our objectives were to exclude pleomorphic dermal sarcomas or other skin tumours incorrectly diagnosed as AFX in our centre after applying strict diagnostic criteria and to assess the behaviour of appropriately diagnosed AFX. Methods We conducted an observational retrospective analysis of 73 patients diagnosed with AFX in our centre between 1998 and 2018. After selecting cases fulfilling AFX criteria, we made an analysis of predictive factors for local recurrence. Crude and sex‐adjusted incidence rates were calculated. Results Out of 73 cases, 62 were eventually diagnosed as AFX. We examined for absence of tumour necrosis, lymphovascular or perineural invasion and infiltration of deep structures. Cytokeratin AE1‐AE3, desmin and CD34 were negative in all cases. The remaining tumours were reclassified. The incidence of AFX in our health‐care area was estimated at 0.59 cases every 100 000 inhabitants per year. In our series, 72.6% of the patients were men with mean age at diagnosis of 81 years. Average tumour diameter was 12 mm. The most common location was head and neck (96.8%). Only four local recurrences were detected over a mean of 47‐month follow‐up. Conclusions We report a series of AFX in our health‐care area. We verify its indolent course when it is properly diagnosed.

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“…These metastatic tumors histologically resemble AFX, but may represent misdiagnosis and may conceal a more aggressive neoplasm, such as squamous cell carcinoma, malignant melanoma, or MFH [3]. A PubMed search to 1970 disclosed no literature on the use of radiation therapy as primary treatment for AFX, and no contraindication to the use of radiations for AFX [2, 6, 10, 11]. Because of the lack of contraindication to the use of radiations in the literature, we elected to treat AFX with electronic brachytherapy.…”

Section: Purposementioning

confidence: 99%

Electronic brachytherapy management of atypical fibroxanthoma: report of 8 lesions

Doggett¹,

Brazil²,

Lı́mová³

et al. 2017

jcb

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PurposeTo evaluate the suitability of treating atypical fibroxanthoma (AFX), an uncommon skin malignancy, with electronic brachytherapy.Material and methodsFrom Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent®, Fremont, California). All lesions received 40 Gy in two fractions per week with 5mm margins.ResultsAt a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy.ConclusionsTo our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.

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Atypical Fibroxanthoma: A case series and review of literature

Cited by 19 publications

References 19 publications

Atypical fibroxanthoma management: Recurrence, metastasis and disease‐specific death

Atypical fibroxanthoma management: Recurrence, metastasis and disease‐specific death

Incidence rate and clinicopathological features of 62 atypical fibroxanthomas in a North‐Western Spanish population

Electronic brachytherapy management of atypical fibroxanthoma: report of 8 lesions

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