Atypical fibroxanthoma (AFX) is a rare cutaneous neoplasm that predominantly affects elderly individuals, typically arising on sun-exposed areas of the head and neck and exhibiting diverse clinical presentations. Histologically, it is composed of atypical spindle cells and is associated with intermediate-grade malignant potential. This case report describes a 76-year-old man diagnosed with recurrent AFX, initially presenting in 2022, with subsequent recurrences in 2023 and 2024 despite adequate excisional surgeries. The patient was ultimately treated with cryotherapy, achieving a 12-month recurrence-free period. Although surgical excision remains the gold standard, there are no universally accepted standardized therapies or guidelines for AFX management. Recent studies, however, have demonstrated the efficacy of non-surgical pharmacological treatments. This report highlights the diagnostic challenges and therapeutic complexities of recurrent AFX, particularly its propensity to mimic more aggressive malignancies.
Apichoto-Mata et al. (Thu,) studied this question.