Atypical Fibroxanthoma in Head and Neck
Our patient was a 70-year-old male who 3 months ago underwent an incision biopsy at another hospital for a 1.0×1.0 cm sized palpable and protruding reddish nodule in the left infra-auricular area. By result of a histological test, a malignant tumor was suspected and he was transferred to our hospital. In the physical examination, there was a round scar remaining from the previously performed biopsy and the size of the resected tissue was approximately 0.7×0.7 cm. Any other special findings were not detected. The specimen acquired at the other hospital was examined again at our hospital. In our histopathologic finding, we detected a numerously mitotic figure with atypical, bizarre, large and hyperchromatic nuclei (). After immunostaining, we had CD34, CD45, cytokeratin and desmin showing negative reaction with a positive reaction for Vimentin as well as CD68. Finally, we diagnosed it as an atypical fibroxanthoma [,]. In addition, the malignancy was confirmed in the previous incision margin, and there was no special findings in a metastatic work-up. Therefore, a wide excision was performed with 2 cm safety resection margin around the lesion which underwent the initial incision biopsy, and there was no malignancy detected by frozen biopsy (). The defect was then closed by simple suture (). Twelve months have passed after surgery and the patient is under the follow-up observation at our outpatient clinic without any local recurrence.