ABSTRACT

Atypical fibroxanthoma (AFX) is a rare tumor that usually arises in sun-damaged skin of the head and neck in elderly people. A 50-year-old male patient presented with a crusted bump on the ear, which had appeared and begun to grow in the course of the previous year. Dermatological examination revealed a dome-shaped, crusted, erythematous, 8 mm in diameter, painless, solitary nodule on the left ear antitragus. Our prediagnoses were basal cell carcinoma, cutaneous leishmaniasis and angiolymphoid hyperplasia. The punch biopsy specimen obtained from the lesion showed that large eosinophilic cells had vacoulated cytoplasms, large nuclei and pleomorphism in the papillary dermis. Giant cell formations and a great number of mitoses were seen in the lesion. Immunohistochemically, it stained positive with S100, but it stained negative with keratin, EMA and desmin. The lesion was diagnosed as AFX and totally removed by excision.