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July 1991

Atypical Fibroxanthoma of the Eyelid and Cheek

Author Affiliations

Little Rock, Ark

Arch Ophthalmol. 1991;109(7):922-923. doi:10.1001/archopht.1991.01080070032018

Atypical fibroxanthoma (AFX) is a fibrohistiocytic tumor that usually occurs in actinically damaged facial skin of the elderly. The tumor is histologically indistinguishable from pleomorphic forms of malignant fibrous histiocytoma. In contrast to malignant fibrous histiocytoma, which occurs in the deep soft tissues and requires radical surgery, AFX originates in the dermis and responds well to localized excision.1,2 Distinguishing this tumor from squamous cell carcinoma may be difficult. We describe a patient with AFX involving the eyelid and cheek to illustrate the clinical and histologic similarities to spindle cell, squamous cell carcinoma.

Report of a Case.  —We treated an 82-year-old man with a 3-cm lesion that developed during a 6-week period in the right lower eyelid and cheek region (Fig 1). The temporal portion of the right lower lid demonstrated ectropion, exposure conjunctivitis, and eyelash loss. Preauricular and cervical lymphadenopathy was absent. The presumed diagnosis was squamous cell carcinoma

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