title: More than 2 decades of treating atypical fibroxanthoma at mayo clinic: what have we learned from 91 patients?
abstract: BACKGROUND
  Atypical fibroxanthoma (AFX) typically occurs on the head and neck of elderly white men. Usually considered a malignancy, it is treated with wide local excision (WLE) or total margin control using Mohs micrographic surgery (MMS).
  
  
  OBJECTIVE
  To determine the most appropriate treatment for this tumor based on a review of cases treated at Mayo Clinic.
  
  
  METHODS
  We reviewed the medical records of patients with AFX treated at Mayo Clinic from 1980 to 2004.
  
  
  RESULTS
  We identified 91 patients with 93 tumors. Treatment information was available for 88 tumors (59 treated with MMS, 23 with WLE, and 6 by other means). There were no recurrences in the patients treated with MMS, with a median follow-up of 4.5 years (range 1.0-16.1 years). Two patients treated with WLE had single recurrences, with a median follow-up of 8.7 years (range 1.5-26.3 years).
  
  
  CONCLUSIONS
  Total microscopic margin control using MMS was the most effective means of treating AFX.
authors.affiliation: Mayo CLinic Rochester, Minnesota 55905, USA.
authors.forename: Gina C
authors.initials: GC
authors.lastname: Ang
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
authors.forename: P
authors.initials: P
authors.lastname: Kim Phillips
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D018219:Histiocytoma, Benign Fibrous / Q000473:pathology / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015580:Mohs Surgery / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014973:Xanthomatosis / Q000473:pathology / Q000601:surgery*