Atypical fibroxanthoma occurs most frequently in the head and neck region of the elderly. Previous reports have identified that the condition usually arises at the following sites: the nose, cheeks, forehead, and the ears; its development at other sites is unusual.
We report a series of 10 cases with lesions all occurring at an apparently unusual site, the scalp, over a 10-year period. We compared the clinical and histologic appearances and behavior of this series with the existing reports of these lesions elsewhere in the head and neck region to investigate whether there were differences with those occurring at a conventional site.
Despite the identification of a range of clinical and histologic findings in our cases, we were unable to find any significant differences with those arising at a conventional site.
This clustering of cases at an apparently unusual site leads us to propose that this condition occurs more commonly on the scalp than current literature suggests. The possibility of its development at this site should be remembered by head and neck surgeons in their differential diagnosis of exophytic lesions of the scalp. © 2001 John Wiley & Sons, Inc. Head Neck 23: 399–403, 2001.