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. 2021 Feb;48(2):207-210.
doi: 10.1111/cup.13787. Epub 2020 Jul 28.

Atypical fibroxanthoma and pleomorphic dermal sarcoma: A reappraisal

Anna Maria Cesinaro  1 , Graziana Gallo  1 , Sabrina Tramontozzi  1   2 , Mario Migaldi  1
Affiliations

Atypical fibroxanthoma and pleomorphic dermal sarcoma: A reappraisal

Anna Maria Cesinaro et al. J Cutan Pathol. 2021 Feb.

Abstract

Background: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) share clinical, pathological, immunohistochemical and molecular features, though PDS is associated with a more aggressive behavior.

Methods: We reviewed 71 tumors fulfilling criteria for AFX and PDS to further stratify their biological potential.

Results: Lesions were mainly located on the scalps of elderly men, and were often ulcerated. One case was necrotic, one showed vascular invasion, and one showed perineural invasion. Fifty-one tumors were limited to reticular dermis (71.8%), 20 invaded subcutaneous tissue, focally in 13 cases (18.3%), and diffusely in seven (9.9%). Subcutaneous invasion was present significantly more often in tumors showing predominantly spindle compared to pleomorphic/mixed cell morphology (P = 0.02). At a follow-up of 17-125 months, 4 cases recurred locally, 4, 6, 10 and 13 months after surgery; no metastases were observed. Three tumors were composed of spindle cells, and one of clear cells. Three cases had margins focally involved, while the fourth case had clear margins.

Conclusion: Depth of invasion and state of margins are criteria predicting prognosis in AFX/PDS; in addition, spindle cell morphology seems to be related to a more infiltrative pattern of growth and to aggressiveness. Grouping these tumors on a morphologic base could help to clarify their different biological behavior.

Keywords: atypical fibroxanthoma; histopathology; metastasis; pleomorphic dermal sarcoma; recurrence.

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References

REFERENCES

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