RT Journal Article
SR Electronic
T1 Progression of the atypical fibroxanthoma to pleomorphic dermal sarcoma in a heart transplant patient
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e242359
DO 10.1136/bcr-2021-242359
VO 14
IS 7
A1 Valeria Ripa
A1 Natasha Singh
A1 Allen E Star
A1 Franz Smith
YR 2021
UL http://casereports.bmj.com/content/14/7/e242359.abstract
AB An 82-year-old man presented with a right scalp lesion which had been increasing in size. The patient’s medical history was significant for a heart transplant 25 years before, and he was on chronic immunosuppression. Biopsy of the lesion showed atypical fibroxanthoma. The patient underwent an excision of the lesion with split thickness skin graft. Pathology showed fibroxanthoma with negative margins. Over the next 9 months, the patient developed new lesions, which were also excised to negative margins. However, with each new lesion, the histology demonstrated increasing dysplasia and ultimately pleomorphic sarcoma. The patient had a metastatic workup with CT of the chest, which was negative, and he underwent a radical scalpectomy, split thickness skin graft placement and adjuvant radiation therapy. The patient has not developed any new scalp lesions and no evidence of metastasis.