Localized cutaneous metastases from an atypical fibroxanthoma

BACKGROUND. Atypical fibroxanthoma is a rare cutaneous spindle cell neoplasm typically found on the sun-exposed areas of the head or neck of the elderly. OBJECTIVE. We report a case of localized cutaneous metastases attributed to an atypical fibroxanthoma. METHODS. A case report and a review of the literature of metastasizing atypical fibroxanthoma are given. RESULTS. Mohs micrographic surgery was used to treat all skin lesions and currently the patient has no suspicious lesions. CONCLUSION. Metastases attributed to atypical fibroxanthoma are rare, and many prior reports may have actually been malignant fibrous histiocytoma, spindle cell melanoma, or spindle cell squamous carcinoma. Tumor depth, vascular invasion, and cutaneous tumor recurrence appear to increase risk for metastasis.