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Atypical fibroxanthoma with regional lymph node metastasis: report of a case and review of the literature.
MedLine Citation:
PMID:  20713774     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Atypical fibroxanthoma (AFX) is a low-grade sarcoma usually occurring on sun-damaged skin of the head and neck in elderly patients. Metastatic disease has been reported very rarely. The potential aggressiveness of AFX is controversial.
OBSERVATIONS: We describe herein a patient who developed metastatic disease in cervical lymph nodes. Our patient was an 87-year-old man with a 7-week history of a rapidly growing AFX presenting as a 1.5-cm sessile nodule on his right mandible. Two months following excision, the patient developed cervical lymphadenopathy. Histopathologic analysis of the cervical lymph nodes revealed spindle-cell tumors with histologic characteristics identical to those of the primary AFX, and the tumors were immunonegative for cytokeratin MNF-116 and S-100. In addition, we review and analyze cases from the literature and articles related to immunohistochemical stains used to diagnose AFX.
CONCLUSIONS: Atypical fibroxanthoma is a diagnosis of exclusion, and only a small number of metastatic AFX cases have been reported. A review of the literature pertaining to immunohistochemical stains suggests the potential benefit of use of CD10, procollagen I, CD99, CD117, p63, and LN-2 in differentiating AFX from other spindle-cell tumors. The metastatic potential of AFX may not be fully appreciated, and clinicians should be reminded of its potential aggressive behavior.
Authors:
Douglas New; Soon Bahrami; Janine Malone; Jeffrey P Callen
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Publication Detail:
Type:  Journal Article     Date:  2010-08-16
Journal Detail:
Title:  Archives of dermatology     Volume:  146     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1399-404     Citation Subset:  AIM; IM    
Affiliation:
310 E Broadway, Floor 2A, Louisville, KY 40202. soonb4@hotmail.com.
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