18F-FDG PET/CT Imaging of Metastatic Atypical FibroxanthomaSheth, Sindu MD; Kim, Andrew MD; Bishop, William D. DO; Bonyadlou, Shahram MD; Henderson, Robert MDClinical Nuclear Medicine: June 2013 - Volume 38 - Issue 6 - p e273–e275 doi: 10.1097/RLU.0b013e3182815b0e Interesting Images Abstract Author Information We report the 18F-FDG PET/CT appearance of a metastatic biopsy-proven malignant fibroxanthoma of the ankle. A 41-year-old female patient with a history of scleroderma presented with a fungating mass in the left ankle. Shave biopsy of the overlying skin showed atypical fibroxanthoma (AFX). Staging FDG PET/CT demonstrated a hypermetabolic exophytic soft tissue mass in the left ankle with local extension to bone and widespread metastatic disease including pulmonary parenchyma, nodes, bone marrow, and skeletal muscle. While rare, knowledge of the potential aggressive nature of AFX is important for accurate diagnosis. From the LAC+USC Medical Center Division of Nuclear Medicine, Department ofRadiology, Keck School of Medicine at University of Southern California, Los Angeles, CA. Received for publication February 7, 2012; revision accepted October 25, 2012. Conflicts of interest and sources of funding: none declared. Reprints: Sindu Sheth, MD, University of Southern California, 1510 San Pablo Street, Suite 350, Los Angeles, CA 90033. E-mail: email@example.com. Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.