Aggressive digital papillary adenocarcinoma: A report of two diseases and review of the literature

Frey, Jamie L; Shimek, Cristina M.; Woodmansee, Courtney; Myers, Erinn M.; Greer, Sarah C.; Liman, Agnes K.; Adelman, Christopher; Rasberry, Ron D.

doi:10.1016/j.jaad.2008.07.038

Cited by 56 publications

(56 citation statements)

References 23 publications

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“…Thus, aggressive adenocarcinoma of the digit should be suspected clinically in a patient with a painful tumor of the digit. 87 This tumor is marked by dermal ductal and tubuloalveolar structures, which have papilla that project into cystlike openings. In addition, these papilla are lined by epithelial cells that project into smaller cystlike structures.…”

Section: Aggressive Digital Papillary Adenocarcinomamentioning

confidence: 99%

Malignant Skin Neoplasms

Ricotti

Bouzari

Agadi³

et al. 2009

Medical Clinics of North America

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Skin cancer is the most common form of cancer in the United States, with the incidence increasing considerably. At current rates in the United States, a skin cancer will develop in 1 in 6 people during their lifetime.1 The most common of skin cancers may be categorized into 2 major groups: melanoma and nonmelanoma skin cancers. The latter group consists primarily of basal cell carcinomas and squamous cell carcinomas. Roughly 1,200,000 nonmelanoma skin cancers develop annually in the United States. These tumors are rarely fatal, but are considered to be fast growing tumors that if neglected may be locally and functionally destructive.In contrast, melanoma represents 5% of all diagnosed cancers in the United States, 15% of which prove to be fatal.3 Although melanoma is seen more with increasing age, it is the most frequent cancer plaguing women aged 25 to 29 years, and the second most frequent cancer afflicting women aged 30 to 34.2 Tumor depth is the most important prognostic indicator for melanoma, thus early recognition and management are imperative for improved therapeutic outcome.Although the nonmelanoma and melanoma skin cancers encompass the vast majority of skin cancers, there is a large number of other malignancies of the skin that are less commonly confronted by the clinician. Neoplasms of the skin classically have been divided into those that differentiate from the epidermis, dermis, adnexal structures of the skin, and those derived systemically. This review focuses on the most frequent malignant neoplasms, and divides them into those that are classically designated nonmelanoma skin cancers (also known as keratinocytic tumors), melanoma, and other less common skin cancers of the skin. An extensive list of skin malignancies is provided in Box 1.

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Section: Aggressive Digital Papillary Adenocarcinomamentioning

confidence: 99%

Malignant Skin Neoplasms

Ricotti

Bouzari

Agadi³

et al. 2009

Medical Clinics of North America

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“…ADPA can be easily forgotten in the differential diagnosis and treatment is often delayed because of misdiagnosis, 3,4 as with our case. In light of previous reports, it is important to have a high clinical suspicion of ADPA when digital lesions such as soft tissue infections, cysts (ganglion, inclusion, mucous), calluses, pyogenic or foreign body granulomas, hemangiomas, osteomyelitis, gout, and cutaneous or subcutaneous tumors (adnexal tumors, squamous cell carcinomas, giant-cell tumors, or metastases of papillary adenocarcinoma originating in the colon, thyroid, or breast) present.…”

Section: Discussionmentioning

confidence: 71%

“…2 ADPA is often misdiagnosed, 3,4 which can delay the standard treatment of excision or amputation. In this study, we report a patient with ADPA that was initially considered to be a benign spiradenoma and was subsequently locally recurrent and progressed to metastatic disease.…”

Section: Introductionmentioning

confidence: 99%

Aggressive Digital Papillary Adenocarcinoma With Multiple Organ Metastases: A Case Report and Review of the Literature

Kobayashi

Hiura

Oishi

et al. 2016

The American Journal of Dermatopathology

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Abstract:Aggressive digital papillary adenocarcinoma (ADPA) is a rare sweat gland neoplasm with a high recurrence rate and metastatic potential. In this study, the authors describe a case that originally appeared to benign spiradenoma, but took an ominous course eventually resulting in the diagnosis of ADPA. A 73-year-old woman developed a gradually growing nodule on the second toe of her left foot, which she had first noticed 4 years previously. An excisional biopsy was performed followed by histological examination. The authors initially considered the tumor to be a benign spiradenoma and did not perform reexcision. However, she experienced local recurrence 24 months later, and multiple pulmonary metastasis 31 months later. On histological examination, both the primary and locally recurrent tumors were found to be composed of discrete and well-circumscribed solid nodules, lacking cystic space. All tumors (the primary tumor, locally recurrent tumor, and lung metastases) presented with a pattern of fused back-to-back tubular structures and myoepithelial differentiation confirmed by immunohistochemical examination. On the basis of these findings, the authors finally diagnosed ADPA with multiple pulmonary metastases. The patient underwent chemotherapy, but died of disease 49 months later. This case highlights the importance of high clinical suspicion of ADPA when digital lesions present.

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“…The tumor originates within the dermis, but extension into the subcutaneous tissue may be present as well as epidermal involvement [2]. Tubuloalveolar and ductal architectural patterns as well as focal infiltration are commonly reported [2, 4, 7]. Variable cytologic atypia has been reported, but these and other histologic parameters have been shown to be poor predictors of metastatic potential in this tumor.…”

Section: Histopathologymentioning

confidence: 99%

“…A variety of histochemical and immunohistochemical stains have been used to differentiate from metastatic adenocarcinoma and other tumors. Dermatologic entities with similarities in histologic appearance include hidradenoma, apocrine cystadenoma, eccrine acrospiroma, papillary eccrine adenoma, apocrine adenoma, chondroid syringoma, and tubular apocrine adenoma [2, 4, 7]. Specimens from these tumors may also be misdiagnosed as metastatic disease due to similarity in histologic architecture to adenocarcinoma of the breast, thyroid, and gastrointestinal tract [2].…”

Section: Histopathologymentioning

confidence: 99%

Aggressive Digital Papillary Adenocarcinoma of the Hand Presenting as a Felon

Bryant

Gardner

Yousif

et al. 2017

Case Reports in Orthopedics

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Aggressive digital papillary adenocarcinoma is a rare eccrine sweat gland malignancy that is frequently misdiagnosed at initial presentation. Histologically, this tumor is similar in appearance to many adenocarcinomas and as such may be diagnosed as a metastatic lesion. We present the case of a patient with digital papillary adenocarcinoma, which was initially diagnosed as a felon. No consensus has been published regarding the treatment of this disease. A review of the diagnosis, pathology, treatment, and adjunctive treatments of aggressive digital papillary adenocarcinoma are also included.

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Aggressive digital papillary adenocarcinoma: A report of two diseases and review of the literature

Cited by 56 publications

References 23 publications

Malignant Skin Neoplasms

Malignant Skin Neoplasms

Aggressive Digital Papillary Adenocarcinoma With Multiple Organ Metastases: A Case Report and Review of the Literature

Aggressive Digital Papillary Adenocarcinoma of the Hand Presenting as a Felon

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