We report a case of atypical fibroxanthoma (AFX) and eruptive actinic keratoses following heart transplantation in a 65-year-old patient. The AFX was diploid with moderate proliferative activity. It recurred and proved to invade the large vessels of these tumors during immunosuppressive therapy highlights the cumulative intervention of ultraviolet light and immune dysregulation in the development of some skin cancers in transplant patients.