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Atypical fibroxanthoma (AFX) is a pleomorphic tumour, first described by Helwig in 1961.1 AFX was thought to be a superficial form of malignant fibrous histiocytoma, but some describe AFX as a reactive lesion that can be confused with pleomorphic carcinomas. Clinically, AFX presents as a 1–2 cm rapidly growing, dome-shaped, polypoid nodule or plaque which may crust or ulcerate.2 AFX is a low-grade sarcoma and is usually cured by excision; however, recurrence and rare metastases have been reported.3
Histological examination shows a dome-shaped …