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Clinical Problem Solving: Pathology
July 2011

Pathology Quiz Case 3: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2011;137(7):729. doi:10.1001/archoto.2011.103-b

Diagnosis: Atypical fibroxanthoma (AFX)

AFX is a superficial cutaneous soft-tissue malignant neoplasm most commonly found in the head and neck region of the elderly. It usually presents as a solitary nonpigmented nodule on sun-exposed skin. The scalp, forehead, nose, cheeks, and ears are common sites, but it has been described elsewhere, including the chest and the shoulders.1,2 It is a rapidly growing tumor and measures between 1.5 and 2 cm in mean diameter on presentation.3 It is typically asymptomatic but may result in ulceration or hemorrhage.4 Although AFX is typically solitary, there have been 3 reports of multifocal AFX in the literature.3