title: Atypical fibroxanthoma: a series of 56 tumors and an unexplained uneven distribution of cases in southeast Germany.
abstract: BACKGROUND
  Atypical fibroxanthoma is a rare mesenchymal tumor of the head and neck region.
  
  
  METHODS
  We analyzed the files of 3 large dermatology hospitals from the years 2001 to 2013 in southeast Germany.
  
  
  RESULTS
  We identified 53 patients (56 tumors) with a male predominance. The mean age was 78.0 years ± 8.3 years. Mohs surgery was performed in all cases resulting in complete remission in 45 patients. Five patients had a relapse within 2 years, and 4 developed metastases. None of the tumors with a safety margin of ≥2 cm relapsed. The majority of cases were found in the Dresden region.
  
  
  CONCLUSIONS
  Atypical fibroxanthoma demonstrates an uneven geographic distribution in southeast Germany that demands further investigations. Mohs surgery with ≥2 cm safety margins is the treatment of choice. A regular follow-up is recommended.
authors.affiliation: Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Institute of Pathology "Georg Schmorl," Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Schönlebe
authors.affiliation: Department of Dermatology, Venereology, and Allergology, University of Leipzig, Leipzig, Germany.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Ziemer
authors.affiliation: Department of Dermatology and Allergology, SHR-Waldklinikum, Gera, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Friedling
authors.affiliation: Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Koch
authors.affiliation: Institute of Pathology "Georg Schmorl," Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: Gunter
authors.initials: G
authors.lastname: Haroske
authors.affiliation: Department of Dermatology and Allergology, SHR-Waldklinikum, Gera, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kaatz
authors.affiliation: Department of Dermatology, Venereology, and Allergology, University of Leipzig, Leipzig, Germany.
authors.forename: Jan-C
authors.initials: JC
authors.lastname: Simon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D018219:Histiocytoma, Benign Fibrous / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Mohs surgery; atypical fibroxanthoma; geographic distribution; risk factors; sarcomas