Atypical
Fibroxanthoma.
Rare skin cancer of the elderly.
Skin Cancer
Atypical fibroxanthoma is a rare Skin Cancer.
Atypical
What is Atypical Fibroxanthoma?
Atypical Fibroxanthoma (AFX) is a rare Skin Tumour that occurs in response to UV light.
The development of these tumours is associated with ageing, sun exposure and/or ionising radiation (X-rays).
Who gets them?
These tumours typically occur on the sun-exposed skin of elderly individuals and are more common in males.
What are the clinical features?
Atypical fibroxanthoma typically appear as a red, juicy, dome-shaped nodule that may be ulcerated or crusted.
They generally start as a small nodule and grow quite quickly over a period of months to a size of about 2-3cm. Multiple tumours can occur and they are usually found on the scalp, cheek and ears.
The appearance is not always specific and can be confused with a squamous cell carcinoma.
Gallery of Fibroxanthoma
Please click on the images for details.
What is the significance?
The final diagnosis of Atypical Fibroxanthoma is made by expert pathological examination of a good quality, deep biopsy sample. Diagnosis is not straightforward, and special stains are often required to distinguish the AFX from ‘undifferentiated pleomorphic sarcoma’ (UPS).
The tumour is low grade but does require surgical excision with wide margins to keep the rate of recurrence to a minimum.
Mohs surgery is an additional option.
Atypical Fibroxanthoma may be diagnosed late for these reasons:
- Older guys may not be looking after themselves by, for example, getting a regular skin check and keeping an eye on their skin.
- The appearance of AFX probably won’t shout out ‘skin cancer’ because the appearance is non specific.
- The condition is rare.
AFX is a significant skin cancer in that treatment is more challenging than SCC or BCC.
Metastases (distance spread) occurs in 0.5% to 4% of cases.
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