Recurrent atypical fibroxanthoma with satellite metastasis

Solomon S. Lee, James Lewis, Kevin Liaw, Lawrence L. Bushkell, Yorke Young, Paul Googe

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Atypical fibroxanthoma (AFX) is a cutaneous neoplasm of uncertain etiology that develops on sun-exposed regions of elderly males. It is widely considered to act indolently, despite its highly malignant cytologic features. Reports of metastatic AFX are very rare, and recurrence is uncommon. We report a case of recurrent AFX exhibiting a pattern of satellite metastasis followed by evidence of regional lymph node metastasis. A 76-year-old male with prior occupational and therapeutic radiation exposure and numerous squamous cell carcinomas had AFX of the left vertex scalp limited to the dermis completely removed by micrographic surgery. Twenty months later, multiple lesions appeared at the site of previous surgery. Imaging revealed no metastases or calvarial involvement. Wide local excision showed multiple well-defined nodules involving dermis and subcutis. The primary and recurrent neoplasms were similar and composed of pleomorphic epithelioid and spindled cells with marked nuclear atypia, hyperchromasia and mitotic activity. Immunohistochemistry was positive for CD10, procollagen1 and vimentin and negative for cytokeratins AE1/AE3, cytokeratins 5/6, 34βE12, MNF116, p63 CD31, Mart1, smooth muscle actin, desmin, S100 and CD34. Forty-eight months after removal of the primary, left intraparotid and posterior triangle lymph nodes are suspected to be involved by metastasis using clinical and positron emission tomography/ computed tomography examinations.

Original languageEnglish (US)
Pages (from-to)56-60
Number of pages5
JournalJournal of cutaneous pathology
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2015

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Neoplasm Metastasis
Dermis
Lymph Nodes
Keratin-6
Keratin-5
Epithelioid Cells
Desmin
Skin Neoplasms
Vimentin
Solar System
Keratins
Scalp
Smooth Muscle
Actins
Squamous Cell Carcinoma
Immunohistochemistry
Recurrence
Neoplasms
Therapeutics
Radiation Exposure

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology

Cite this

Recurrent atypical fibroxanthoma with satellite metastasis. / Lee, Solomon S.; Lewis, James; Liaw, Kevin; Bushkell, Lawrence L.; Young, Yorke; Googe, Paul.

In: Journal of cutaneous pathology, Vol. 42, No. 1, 01.01.2015, p. 56-60.

Research output: Contribution to journalArticle

Lee, Solomon S. ; Lewis, James ; Liaw, Kevin ; Bushkell, Lawrence L. ; Young, Yorke ; Googe, Paul. / Recurrent atypical fibroxanthoma with satellite metastasis. In: Journal of cutaneous pathology. 2015 ; Vol. 42, No. 1. pp. 56-60.
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