Commentary to the Article “A Rare Collision in Dermatopathology: Basal Cell Carcinoma and Atypical Fibroxanthoma”

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To the Editor:
We read with great interest the article “A Rare Collision in Dermatopathology: Basal Cell Carcinoma and Atypical Fibroxanthoma”1 and would like to congratulate the authors for their article. The authors presented a rare collision tumor that comprised a basal cell carcinoma (BCC) and an atypical fibroxanthoma (AFX) in a 64-year-old male patient.
This association of 2 or more different tumors in a single cutaneous lesion is a rare situation and can lead to diagnostic challenges. The presence of BCC with other lesions is known, although the association of AFX with other tumors is very rare.2
As stated by the authors, there is “only 1 other case reported in the literature,” regarding this type of collision tumor (BCC and AFX). The authors failed to mention the reference of the article, so we would like to highlight our article “Basal cell carcinoma and atypical fibroxanthoma: an unusual collision tumor,3” which might correspond to the case referred by the authors.
In our article, we presented the association of BCC and AFX, in a 85-year-old female and, at that time, no “collision tumor” with this association had been previously reported. After confirmation through histopathologic examination, the tumor was treated with a Mohs excision.
We have previously remarked that these collision tumors raise clinical, dermoscopic, and histopathologic challenges, which is in accordance with the article published by Speiser et al.
The knowledge of the collision of these 2 malignant tumors could alert clinicians and dermatopathologists to diagnose tumors with atypical clinical presentation and diagnostic difficulties.

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