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

Australas J Dermatol. 2018 Feb;59(1):10-25. doi: 10.1111/ajd.12646. Epub 2017 Aug 17.

Abstract

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.

Keywords: AFX; AFX management; AFX treatment; atypical fibroxanthoma; review.

Publication types

  • Review

MeSH terms

  • Disease-Free Survival
  • Fibroma / mortality
  • Fibroma / pathology*
  • Fibroma / surgery*
  • Humans
  • Immunocompromised Host
  • Margins of Excision
  • Mohs Surgery
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm, Residual
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery*
  • Xanthomatosis / mortality
  • Xanthomatosis / pathology*
  • Xanthomatosis / surgery*