Skip to main content
SpringerLink
Log in

Rezidivierendes und metastasierendes atypisches Fibroxanthom

Recurrent and metastasizing atypical fibroxanthoma

  • Kasuistiken
  • Published:
HNO Aims and scope Submit manuscript

Zusammenfassung

Das atypische Fibroxanthom ist ein seltener Hauttumor, der vor allem auf sonnenexponierter Haut auftritt. Obwohl er als gutartiger Tumor bezeichnet wird, treten vereinzelt Metastasen auf. Die exakte Einordnung von solchen agressiveren Verläufen des atypischen Fibroxanthoms ist derzeit noch Gegenstand der Diskussion. Präsentiert wird der Fall eines 81-jährigen Patienten mit rezidivierendem atypischem Fibroxanthom im Bereich der rechten Ohrmuschel. Beim zweiten Rezidiv trat gleichzeitig eine solitäre Metastase in der Glandula parotidea rechts auf. Es erfolgte schließlich die komplette Tumorentfernung, die postoperativ indizierte Radiotherapie wurde vom Patienten abgelehnt. Der Patient ist seit 60 Monaten rezidivfrei. Die Tumorentität „atypisches Fibroxanthom“ und die entsprechende Therapie werden anhand dieses Beispiels beschrieben und die neuesten Erkenntnisse zu dieser Erkrankung mittels der aktuellen Literatur diskutiert.

Summary

Atypical fibroxanthoma is a rare skin tumor that arises particularly on sun-exposed skin. Although it is considered to be a benign tumor, rarely, metastases arise. The accurate classification of aggressive processes of atypical fibroxanthoma is currently still the subject of discussion. The case of an 81-year-old patient with relapsing atypical fibroxanthoma of the right auricle is presented. With the second relapse, a single metastasis in the right parotid gland was detected. A complete tumor excision was performed, and the patient declined the recommended postoperative radiotherapy. The patient has not show any signs of relapse for 60 months now. Atypical fibroxanthoma and the appropriate therapy for it are described, and the newest discoveries regarding this disease are discussed on the basis of the current literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Anderson PJ, McPhaden AR, Ratcliffe RJ (2001) Atypical fibroxanthoma of the scalp. Head Neck 23: 399–403

    Article  PubMed  CAS  Google Scholar 

  2. Brown MD, Swanson NA (1989) Treatment of malignant fibrous histiozytoma and atypical fibrous xanthomas with micrographic surgery. Dermatol Surg 15: 1287–1292

    CAS  Google Scholar 

  3. Cooper JZ, Newman SR, Scott GA, Brown MD (2005) Metastasizing atypical fibroxanthoma (cutaneous malignant histiocytoma): report of five cases. Dermatol Surg 31: 221–225

    Article  PubMed  CAS  Google Scholar 

  4. Dahl I (1976) Atypical fibroxanthoma of the skin. A clinicopathological study of 57 cases. Acta Pathol Microbiol Scand [A] 84: 183–197

    Google Scholar 

  5. Davis JL, Randle HW, Zalla MJ et al. (1997) A comparison of Mohs micrografic surgery and wide excision with for the treatment of atypical fibroxanthoma. Dermatol Surg 23: 105–110

    Article  PubMed  Google Scholar 

  6. Dei Tos AP, Maestro R, Doglioni C et al. (1994) Ultraviolett-induced p53 mutations in atypical fibroxanthoma. Am J Pathol 145: 11–17

    Google Scholar 

  7. Dettrick A, Strutton G (2006) Atypical fibroxanthoma with perineural or intraneural invasion: report of two cases. J Cutan Pathol 33: 318–322

    Article  PubMed  Google Scholar 

  8. Enzinger FM, Weiss SW (2001) Soft tissue tumors. Malignant fibrohistiozytic tumors. 3rd edn, pp 535–569, Mosby, St. Louis

  9. Fletscher CDM, Berg E van den, Molenhaar WM (2002) Pleomorphic malignant fibrous histiocytoma / Undifferentiated high grade pleomorphic sarcoma. In: Fletscher CDM, Unni KK, Mertens F (eds) Tumors of soft tissue and bone. IARC, Lyon, pp 120–122

  10. Fretzin DF, Helwig EB (1973) Atypical fibroxanthoma of the skin: a clinicopathologic study of 140 cases. Cancer 31: 1541–1552

    Article  PubMed  CAS  Google Scholar 

  11. Glavin FL, Cornwell ML (1985) Atypical fibroxanthoma of the skin metastatic to the lung. Report of a case, features by conventional and electron microscopy, and review of relevant literature. Am J Dermatopathol 7: 57–63

    Article  PubMed  CAS  Google Scholar 

  12. Grosso M, Lentini M, Carozza G, Catalano A (1987) Metastatic atypical fibroxanthoma of the skin. Pathol Res Pract 182: 443–447

    PubMed  CAS  Google Scholar 

  13. Giuffrida TJ, Kligora CJ, Goldstein GD (2004) Localized cutaneous metastases from an atypical fibroxanthoma. Dermatol Surg 30: 1561–1564

    Article  PubMed  CAS  Google Scholar 

  14. Hakim I (2001) Atypical fibroxanthoma. Ann Otol Rhinol Laryngol 110: 985–987

    PubMed  CAS  Google Scholar 

  15. Hanly AJ, Jorda M, Elgart GW et al. (2006) High proliferative activity excludes dermatofibroma: report of the utility of MIB-1 in the differential diagnosis of selected fibrohistiocytic tumors. Arch Pathol Lab Med 130: 831–834

    PubMed  CAS  Google Scholar 

  16. Heintz PW, White CR (1999) Diagnosis: atypical fibroxanthoma or not? Evaluating spindle cell malignancies on sun damaged skin: a practical approach. Semin Cutan Med Surg 18: 78–83

    Article  PubMed  CAS  Google Scholar 

  17. Helwig EB, May D (1986) Atypical fibroxanthoma of the skin with metatasis. Cancer 57: 368–376

    Article  PubMed  CAS  Google Scholar 

  18. Jacobs DS, Edwards WD, Ye RC (1975) Metastatic atypical fibroxanthoma of the skin. Cancer 35: 457–463

    Article  PubMed  CAS  Google Scholar 

  19. Jensen K, Wilkonson B, Wines N, Kossard S (2004) Procollagen I expression in atypical fibroxanthoma and other tumors. J Cutan Pathol 31: 57–61

    Article  PubMed  Google Scholar 

  20. Jensen KJ, Peterson SR (2006) Multiple recurrent atypical fibroxanthomas/superficial malignant fibrous histiocytomas of the forehead excised with Mohs micrographic surgery. Dermatol Surg 32: 588–591

    Article  PubMed  CAS  Google Scholar 

  21. Khan H, Shim H, Phelps RG (1996) Atypical fibroxanthoma and malignant fibrous histiocytoma: a comparative immunhistochemical and histiogenetic study. J Cutan Pathol 23: 79A

    Google Scholar 

  22. Kargi E, Gungor E, Verdi M et al. (2003) Atypical fibroxanthoma and metastasis to the lung. Plast Reconstr Surg 111: 1760–1762

    Article  PubMed  Google Scholar 

  23. Kemp JD, Stenn KS, Arons M, Fisher J (1978) Metastasizing atypical fibroxanthoma: coexistence with chronic lymphocytic leukemia. Arch Dermatol 114: 1533–1535

    Article  PubMed  CAS  Google Scholar 

  24. Lazova R, Moynes R, May D, Scott G (1997) LN-2 (CD74) – A marker to distinguish atypical fibroxanthoma from malignant histiozytoma. Cancer 79: 2115–2124

    Article  PubMed  CAS  Google Scholar 

  25. Longacre TA, Smoller BR, Rouse RV (1993) Atypical fibroxanthoma. Multiple immunohistologic profiles. Am J Surg Pathol 17: 1199–1209

    Article  PubMed  CAS  Google Scholar 

  26. Lum DR, King AR (2006) Peritoneal metastases from an atypical fibroxanthoma. Am J Surg Pathol 30: 1041–1046

    Article  PubMed  Google Scholar 

  27. Ly H, Selva D, James GL, Huilgol SC (2004) Superficial malignant fibrous histiocytoma presenting as recurrent atypical fibroxanthoma. Australas J Dermatol 45: 106–109

    Article  PubMed  Google Scholar 

  28. Monteagudo C, Calduch L, Navarro S et al. (2002) CD 99 Immunoreactivity in atypical fibroxanthoma. Anat Pathol 117: 126–131

    Google Scholar 

  29. Mirza B, Weedon D (2005) Atypical fibroxanthoma: A clinicopathological study of 89 cases. Australas J Dermatol 46: 235–238

    Article  PubMed  Google Scholar 

  30. Muenster MR, Hoang MP (2006) Left facial mass in an elderly man. Metastasizing atypical fibroxanthoma of the skin. Arch Pathol Lab Med 130: 735–736

    PubMed  Google Scholar 

  31. Oshiro Y, Fukuda T, Tsuneyoshi M (1995) AFX versus benign and malignant fibrous histiozytoma. A comparative study of their proliferative activity using MIB-1, DNA flow cytometry and p53 immunostaining. Cancer 75: 1128–1134

    Article  PubMed  CAS  Google Scholar 

  32. Rizzardi C, Angiero F, Melato M (2003) Atypical fibroxanthoma and malignant fibrous histiocytoma of skin. Anticancer Res 2C: 1847–1851

    Google Scholar 

  33. Sakamoto A, Oda Y, Itakura E et al. (2001) Immunoexpression of ultraviolet photoproducts and p53 mutation analysis in atypical fibroxanthoma and superficial malignant fibrous histiocytoma. Mod Pathol 14: 581–588

    Article  PubMed  CAS  Google Scholar 

  34. Sakamoto A, Oda Y, Itakura E et al. (2001) H-, K-, and N-ras gene mutation in atypical fibroxanthoma and malignant fibrous histiozytoma. Hum Pathol 32: 1225–1231

    Article  PubMed  CAS  Google Scholar 

  35. Sankar NM, Pang KS, Thiruchelvam T (1998) Metastasis from atypical fibroxanthoma of skin. Med J Aust 168: 418–419

    PubMed  CAS  Google Scholar 

  36. Seavolt M, McCall M (2006) Atypical fibroxanthoma: review of the literature and summary of 13 patients treated with mohs micrographic surgery. Dermatol Surg 32: 435–441

    Article  PubMed  CAS  Google Scholar 

  37. Skoulas IG, Price M, Andrew J, Kountakis SE (2001) Recurrent atypical fibroxanthoma of the cheek. Am J Otolaryngol 22: 73–75

    Article  PubMed  CAS  Google Scholar 

  38. Stadler FJ, Scott GA, Brown MD (1998) Malignant fibrous tumors. Semin Cutan Med Surg 17: 141–152

    Article  PubMed  CAS  Google Scholar 

  39. Weedon D, Williamson R, Mirza B (2005) CD10, a useful marker for atypical fibroxanthomas. Am J Dermatopathol 27: 181

    Article  PubMed  Google Scholar 

  40. Worrell JT, Ansari MQ, Ansari SJ, Cockerell CJ (1993) Atypical fibroxanthoma: DNA ploidy analysis of 14 cases with possible histogenetic implications. J Cutan Pathol 20: 211–215

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland

    M. Koch & C. Alexiou

  2. Pathologisches Institut, Friedrich-Alexander-Universtät Erlangen-Nürnberg, Erlangen, Deutschland

    A. Dimmler

Authors
  1. M. Koch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Dimmler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Alexiou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Koch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koch, M., Dimmler, A. & Alexiou, C. Rezidivierendes und metastasierendes atypisches Fibroxanthom. HNO 56, 1046–1051 (2008). https://doi.org/10.1007/s00106-007-1636-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-007-1636-3

Schlüsselwörter

Keywords

Search

Navigation