Abstract
Atypical fibroxanthoma (AFX) is a rare dermal neoplasm of low-intermediate malignant potential found almost exclusively in the non-mucosal regions of the head and neck in light-skinned elderly males who have a history of significant sun exposure.
 Due to its risk of misdiagnosis of more common skin lesions and possibility of metastases, AFX requires resection with either Mohs Micrographic Surgery (MMS) or wide local excision (WLE). The purpose of this abstract is to discuss the best comprehensive treatment for a lower lip AFX using MMS versus WLE.
Highlights
Atypical fibroxanthoma (AFX) is a rare (0.002% of all non-melanoma skin cancers) cutaneous neoplasm of fibrohistiocytic mesenchymal origin and low-intermediate malignant potential
A 73-year-old female with a history of significant sun damage and non-melanocytic skin cancer presented to the clinic with the complaint of an enlarging lower lip lesion that did not improve with the use of OTC products
Patients treated with Mohs Micrographic Surgery (MMS) have a recurrence rate of 2-4.6%, often within [1-3] years of resection
Summary
Atypical fibroxanthoma (AFX) is a rare (0.002% of all non-melanoma skin cancers) cutaneous neoplasm of fibrohistiocytic mesenchymal origin and low-intermediate malignant potential. AFX presents as a rapidly growing, solitary, red-pink, firm nodule with a mean diameter less than 2 cm and occasionally may ulcerate or bleed These tumors present almost exclusively in the non-mucosal regions of the head and neck in light-skinned elderly males who have a history of significant sun exposure. Ultraviolet (UV) radiation exposure leading to p53 mutations and cyclobutene pyrimidine dimers is the primary risk factor for development of AFX. These tumors possess a predilection for sun-exposed areas in CASE REPORT. A 73-year-old female with a history of significant sun damage and non-melanocytic skin cancer presented to the clinic with the complaint of an enlarging lower lip lesion that did not improve with the use of OTC products.
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