{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:13:50Z","timestamp":1759335230360},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,12,29]],"date-time":"2014-12-29T00:00:00Z","timestamp":1419811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:p>Atypical fibroxanthoma (<jats:styled-content style=\"fixed-case\">AFX<\/jats:styled-content>) is a cutaneous neoplasm of uncertain etiology that develops on sun\u2010exposed regions of elderly males. It is widely considered to act indolently, despite its highly malignant cytologic features. Reports of metastatic <jats:styled-content style=\"fixed-case\">AFX<\/jats:styled-content> are very rare, and recurrence is uncommon. We report a case of recurrent <jats:styled-content style=\"fixed-case\">AFX<\/jats:styled-content> exhibiting a pattern of satellite metastasis followed by evidence of regional lymph node metastasis. A 76\u2010year\u2010old male with prior occupational and therapeutic radiation exposure and numerous squamous cell carcinomas had <jats:styled-content style=\"fixed-case\">AFX<\/jats:styled-content> of the left vertex scalp limited to the dermis completely removed by micrographic surgery. Twenty months later, multiple lesions appeared at the site of previous surgery. Imaging revealed no metastases or calvarial involvement. Wide local excision showed multiple well\u2010defined nodules involving dermis and subcutis. The primary and recurrent neoplasms were similar and composed of pleomorphic epithelioid and spindled cells with marked nuclear atypia, hyperchromasia and mitotic activity. Immunohistochemistry was positive for <jats:styled-content style=\"fixed-case\">CD10<\/jats:styled-content>, procollagen1 and vimentin and negative for cytokeratins <jats:styled-content style=\"fixed-case\">AE1<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AE3<\/jats:styled-content>, cytokeratins 5\/6, 34\u03b2<jats:styled-content style=\"fixed-case\">E12<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">MNF116<\/jats:styled-content>, p63 <jats:styled-content style=\"fixed-case\">CD31<\/jats:styled-content>, Mart1, smooth muscle actin, desmin, <jats:styled-content style=\"fixed-case\">S100<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CD34<\/jats:styled-content>. Forty\u2010eight months after removal of the primary, left intraparotid and posterior triangle lymph nodes are suspected to be involved by metastasis using clinical and positron emission tomography\/ computed tomography examinations.<\/jats:p>","DOI":"10.1111\/cup.12447","type":"journal-article","created":{"date-parts":[[2014,11,19]],"date-time":"2014-11-19T08:29:18Z","timestamp":1416385758000},"page":"56-60","source":"Crossref","is-referenced-by-count":8,"title":["Recurrent atypical fibroxanthoma with satellite metastasis"],"prefix":"10.1111","volume":"42","author":[{"given":"Solomon S.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pathology University of Tennessee Graduate School of Medicine  Knoxville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Graduate School of Medicine  Knoxville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Liaw","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Tennessee Graduate School of Medicine  Knoxville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence L.","family":"Bushkell, Jr","sequence":"additional","affiliation":[{"name":"Knoxville Dermatology Group  Knoxville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yorke D.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Tennessee Graduate School of Medicine  Knoxville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul B.","family":"Googe","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Tennessee Graduate School of Medicine  Knoxville TN USA"},{"name":"Knoxville Dermatopathology Laboratory  Knoxville TN USA"},{"name":"Department of Pathology Vanderbilt University  Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,29]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3181c80b97"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2005.00190.x"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197306)31:6<1541::AID-CNCR2820310635>3.0.CO;2-6"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2009.01255.x"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3181c183f9"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2008.01084.x"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0303-6987.2006.00427.x"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1997.tb01573.x"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.dad.0000246175.73447.3a"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0303-6987.2005.00326.x"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0303-6987.2006.00412.x"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2009.01425.x"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31816b8fce"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2010.01843.x"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e31827a0b98"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2006.00635.x"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2008.01179.x"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2006.00492.x"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.1309\/2EXB-70CW-3U6P-VQ6H"},{"key":"e_1_2_4_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2010.01532.x"},{"key":"e_1_2_4_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2011.01802.x"},{"key":"e_1_2_4_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2009.01126.x"},{"key":"e_1_2_4_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1997.tb00670.x"},{"key":"e_1_2_4_25_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.112381"},{"key":"e_1_2_4_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2006.32087.x"},{"key":"e_1_2_4_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1977.tb15062.x"},{"key":"e_1_2_4_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200608000-00017"},{"key":"e_1_2_4_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2011.01851.x"},{"key":"e_1_2_4_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2010.206"},{"key":"e_1_2_4_31_1","first-page":"403","volume-title":"Atypical fibroxanthoma. 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