Title: Aggressive Digital Papillary Adenocarcinoma (ADPCA) of heel with Distant Lung Metastasis: A Rare Presentation

Authors: Dr Shabnum Thakur, Dr Vikas Fotedar, Dr Manish Gupta, Dr Anchana Gulati

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.49

Abstract

Aggressive digital papillary adenocarcinoma (ADPCA) is rare tumour of the sweat glands, characterised by lesions on the fingers, toes and the digits. The lesion is serious but often overlooked because it is confused clinically with benign and non-tumorous entities. Here, we present an interesting case of ADPCA in a 55-year-old male, suspected clinically as pyogenic granuloma, with the initial excision biopsy indicating a malignant tumour in the sweat gland. The histopathological features were studied in detail, along with required markers. The documentation of such malignant tumour is limited in literature. It requires a high index of suspicion and a prudent approach while dealing with all masses arising in the extremities.

Keywords: Digital carcinoma, histopathology, recurrence, metastasis.

References

  1. Rafee A, Prasad G, Phang S, Ramesh P. Aggressive digital papillary adenocarc-inoma of the hand. J Hand SurgEur Vol. 2007;32(3):275–276.
  2. Gorva AD, Mohil R, Srinivasan MS. Aggressive digital papillary adenocar-cinoma presenting as a paronychia of the finger. J Hand Surg Br. 2005;30(5):534.
  3. LeBoit PE, Burg G, Weedon D, Sarasin A. World Health Organization classification of tumours: pathology and genetics of skin tumours. Lyon: IARC Press, 2006; 133­4.
  4. Helwig EB. Aggressive digital papillary adenoma. In:American Aca­ demy of Dermatology and Clinical Pathology Conference; 1979 Dec 5; Chicago, IL, USA.
  5. Kao GF, Helwig EB, Graham JH. Aggressive digital papillary adenoma and adenocarcinoma: a clinicopathological study of 57 patients, with histochemical, immunopathological, and ultrastructural observations. J CutanPathol 1987; 14: 129­46.
  6. Paerson JW, Wick MR. Atlas of tumor pathology fourth series: non­ melanocytic tumours of the skin. AFIP atlas of tumour pathology, series Washington, DC: American Registry of Pathology and Armed Forces Institute of Pathology, 2006; 157­8.
  7. Suchak R, Wang WL, Prieto VG, et al. Cutaneous digital papillary adenocar-cinoma: a clinicopathologic study of 31 cases of a rare neo­ plasm with new observations. Am J SurgPathol 2012; 36: 1883­91.
  8. Duke WH, Sherrod TT, Lupton GP. Aggressive digital papillary adenocarc-inoma (aggressive digital papillary adenoma and adeno­ carcinoma revisited). Am J SurgPathol 2000; 24: 775­84.

Corresponding Author

Shabnum Thakur, Junior Resident

MD Radiotherapy, Department of Radiotherapy, IGMC Shimla (HP), India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone no. 9459830966