World J Oral Maxillofac Surg | Volume 1, Issue 2 | Case Report | Open Access

Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma- Two Stages of the Same Disease?

Farhana Kapasi^1*, Marta Cabral², Phillip Ameerally¹ and Antonia Barbieri¹

¹Department of Oral and Maxillofacial Surgery, Northampton General Hospital, UK
²Marta Cabral, The Royal Devon and Exeter NHS Foundation Trust, UK

^*Correspondance to: Farhana Kapasi 

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Abstract

Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma are rare cutaneous neoplasm's which share clinical and Histopathological features which can pose a diagnostic challenge. Atypical Fibroxanthoma has been considered a low-grade malignancy whereas Pleomorphic Dermal Sarcoma has been considered high grade and aggressive. We report a case of an 83-year-old male with a history of Actinic Keratosis who presented with an erythematous papule on the right parietal scalp. Histopathological diagnosis was Atypical Fibroxanthoma. Seven months postoperatively, the patient developed a rapidly growing purple nodule at the operative site which was adherent to the skull. Histopathological diagnosis was Pleomorphic Dermal Sarcoma with bone involvement. We suggest that the recurrence rate and low aggressive potential of Atypical Fibroxanthoma may have been underestimated, as these tumours are rare and have not been widely reported in the literature. In this case, the tumour recurred following complete excision. The recurrence was the more infiltrative Pleomorphic Dermal Sarcoma, which reinforces the hypotheses that Atypical Fibroxanthoma may be the precursor lesion of Pleomorphic Dermal Sarcoma and that these are indeed two stages of the same disease rather than separate entities.

Keywords:

General dermatology; Medical dermatology; Head and neck oncology

Citation:

Kapasi F, Cabral M, Ameerally P, Barbieri A. Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma - Two Stages of the Same Disease? World J Oral Maxillofac Surg. 2018;1(2):1009.