Treatment
Surgical Care
In the past, many lesions were diagnosed clinically as pyogenic granuloma and removed by shave and curettage, without recurrence, which has prompted physicians to treat atypical fibroxanthoma (AFX) conservatively. Local recurrence and spread to lymph nodes may occur. [14, 15] This suggests that complete tumor removal is required. Simple excision with a margin of normal skin or Mohs micrographic surgery may be appropriate.
Mohs micrographic surgery, with its high reliability of complete tumor removal and tissue-conserving property, is an excellent choice for AFX on the head and neck. [16, 17, 18, 19, 20, 21]
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Media Gallery
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Red, beefy, sessile nodule typical of clinical presentation of atypical fibroxanthoma. Note the markedly sun-damaged skin with solar telangiectasias. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
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Microscopic view of atypical fibroxanthoma. Note the large abnormal-appearing cells in a field of spindle cells. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
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