Atypical Fibroxanthoma of the Medial Canthus: A Rare Presentation

Rathore, Deepa; Mohyudin, Mohamed N.; Mehta, Purnima; Ahluwalia, Harpreet

doi:10.3109/01676830.2013.771680

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…However, these cases are now considered to be atypical fibrous histiocytomas, not AFX. Rare locations include medial canthus [6], eyelids [7], limbus [8], subungual region [9], lip mucosa [10] and ethmoid sinus [11][12][13].…”

Section: Clinical Features Of Afxmentioning

confidence: 99%

Atypical fibroxanthoma: new insights

Hussein

2014

Expert Review of Anticancer Therapy

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Atypical fibroxanthoma (AFX) is an ultraviolet radiation-associated dermal neoplasm. To address the clinicopathologic and molecular features of this particular neoplasm. The author conducted a literature review using PubMed searching for articles relating to AFX. AFX usually appears as a rapidly growing nodular or nodulo-ulcerative lesion. It occurs on sun-exposed skin of elderly peoples. AFX may be composed predominantly of pleomorphic, spindle, epithelioid cells, or admixture of these cells. The differential diagnosis of AFX includes pleomorphic dermal sarcoma, squamous cell carcinoma, malignant melanoma and leiomyosarcoma. Several observations favor a mesenchymal origin for AFX. These reviews address the clinicopathologic features, molecular pathology, prognosis and treatment of this neoplasm.

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Section: Clinical Features Of Afxmentioning

confidence: 99%

Atypical fibroxanthoma: new insights

Hussein

2014

Expert Review of Anticancer Therapy

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“…There have only been a few reported cases of ocular surface presentation of this tumor, and only one has been reported in patients without xeroderma pigmentosum. Other reported locations of ocular atypical fibroxanthoma include the palpebral conjunctiva, limbus, and medial canthus [4,7,8]. …”

Section: Discussionmentioning

confidence: 99%

Atypical Fibroxanthoma of the Bulbar Conjunctiva: A Unique Case Describing the Pathology, Clinical Presentation, and Management

et al. 2017

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Background/Aims: Atypical fibroxanthoma is an uncommon tumor that usually occurs in the skin of the head and neck of the elderly with significant sun exposure. We describe a unique case featuring a rare ocular surface conjunctival tumor (atypical fibroxanthoma) and provide insight on its characteristic clinical features, surgical management, and histology. Methods: A 71-year-old male fisherman with no pertinent ocular history presented to an academic center with a rapidly enlarging bulbar conjunctival mass in the right perilimbal region for the past several months. The patient underwent surgical excisional biopsy with cryotherapy, adjuvant alcohol, and amniotic membrane transplantation. Results: Pathology specimen illustrated an atypical spindle cell tumor with inflammatory cells, increased mitotic activity, cytologic atypia, and positive diffuse staining with CD163 and CD10 consistent with an atypical fibroxanthoma. Conclusion: Atypical fibroxanthoma is an extremely rare ocular surface tumor that may simulate conjunctival or ocular surface squamous neoplasia. While this lesion typically pursues a benign clinical course, it may recur or rarely metastasize. Thus it should be treated aggressively with excisional biopsy, cryotherapy, absolute alcohol, and/or amniotic membrane transplantation.

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Surgical excision margins for fibrohistiocytic tumors, including atypical fibroxanthoma and undifferentiated pleomorphic sarcoma: A probability model based on a systematic review

Jibbe¹,

Worley²,

Miller³

et al. 2022

Journal of the American Academy of Dermatology

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Background: Mohs micrographic surgery or wide local excision is the treatment of choice for fibrohistiocytic tumors with metastatic potential, including atypical fibroxanthoma (AFX) and cutaneous undifferentiated pleomorphic sarcoma (cUPS). Since margin clearance is the strongest predictor of clinical recurrence, improved recommendations for appropriate surgical margins help delineate uniform excision margins when intraoperative margin assessment is not available.Objective: To determine appropriate surgical wide local excision margins for AFX and cUPS.Methods: Literature search (Ovid MEDLINE, Embase, Web of Science, and Cochrane Library from inception to March 2020) to detect case-level data. Estimation of margins required using a mathematical model based on extracted cases without recurrences.Results: Probabilistic modeling based on 100 cases extracted from 37 studies showed peripheral clearance margin (ie, wide local excision margin) calculated to clear 95% of all tumors was 2 cm for AFX and 3 cm for cUPS. AFX tumors 1 cm or less required a margin of 1 cm.Limitations: Data were extracted from published cases.Conclusions: Atypical fibroxanthoma removed with at least a 2-cm peripheral excision margin is less likely to recur. Smaller tumors 1 cm or less can be treated with a more conservative margin. Margin-control surgical techniques are recommended to ensure complete removal while minimizing surgical morbidity.

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Atypical Fibroxanthoma of the Medial Canthus: A Rare Presentation

Cited by 6 publications

References 9 publications

Atypical fibroxanthoma: new insights

Atypical fibroxanthoma: new insights

Atypical Fibroxanthoma of the Bulbar Conjunctiva: A Unique Case Describing the Pathology, Clinical Presentation, and Management

Surgical excision margins for fibrohistiocytic tumors, including atypical fibroxanthoma and undifferentiated pleomorphic sarcoma: A probability model based on a systematic review

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