Division of Plastic Surgery, Queen's University, Kingston, Ontario, Canada.
J Surg Oncol. 2012 May;105(6):559-62. doi: 10.1002/jso.22128. Epub 2011 Oct 24.
Atypical fibroxanthoma (AFX) is an uncommon skin tumor occurring primarily in the head and neck region of elderly Caucasian males. Treated with local excision, the disease is thought to be fairly benign but can occasionally demonstrate aggressive local recurrence as well as distant metastasis.
Seventy-one cases of AFX were reviewed, representing all patients presenting to the Health Sciences Centre of South Eastern Ontario with the diagnosis of AFX in the period 1989-2008. Demographic and pathologic data were obtained from patient charts for analysis.
Mean age at presentation was 76, with a male:female ratio of 4:1. Recurrence occurred in 10 patients after an average period of 7.3 months. Three recurrent lesions went on to distant metastasis, on average 14.3 months after initial presentation. The remaining 60 tumors did not recur. Histologically, tumor extending beyond the dermis into the underlying adipose and muscular tissue had a 29.4% chance of local recurrence and an 11.8% chance of metastasis compared to lesions confined to the dermis only (9.3% and 1.8%).
While the majority of AFX presentations are benign, there is a real possibility of metastatic spread. Invasion beyond the dermis and a rapid rate of recurrence are suggestive of a more aggressive clinical course.
非典型纤维黄色瘤（AFX）是一种罕见的皮肤肿瘤，主要发生在老年白种人头部和颈部。通过局部切除进行治疗，该疾病被认为是相当良性的，但偶尔也会表现出侵袭性局部复发和远处转移。
回顾了 71 例 AFX 病例，这些病例代表了 1989 年至 2008 年间在安大略省东南部卫生科学中心就诊并诊断为 AFX 的所有患者。从患者病历中获取人口统计学和病理学数据进行分析。
平均发病年龄为 76 岁，男女比例为 4:1。平均 7.3 个月后，10 例患者出现复发。3 例复发性病变平均在初次就诊后 14.3 个月发生远处转移。其余 60 个肿瘤未复发。组织学上，肿瘤延伸至真皮以下的脂肪和肌肉组织，局部复发的几率为 29.4%，转移的几率为 11.8%，而仅局限于真皮的病变局部复发的几率为 9.3%，转移的几率为 1.8%（9.3%和 1.8%）。
虽然大多数 AFX 表现为良性，但确实存在转移的可能性。真皮以外的侵犯和快速复发提示更具侵袭性的临床病程。
