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Atypical fibroxanthoma (AFX) is a rare dermal spindle-cell sarcoma, considered a relatively benign type of skin cancer. Clinically, it presents as localized red nodules or plaques, and most commonly affects the head and neck of elderly individuals with sun-damaged skin. In this report, we present the case of a 92-year-old woman diagnosed with AFX on the left dorsum. Initially, she underwent surgical excision and was followed up in the clinic. However, after a 10-month follow-up period, the tumor recurred, and a second surgical excision was performed. Pathological examination revealed a malignant fibrous histiocytoma transformation of the AFX, a rare occurrence in the prognosis of AFX.