Digital papillary adenocarcinoma of the ankle

Abstract

Digital Papillary Adenocarcinoma (DPA) is a very rare neoplasm of sweat glands, with approximately 100 cases in the literature. We present a rare case of DPA of the ankle in a 66-year-old African American man. DPA has a high potential for metastases to the lung and lymph nodes, and initial treatment often entails wide excision or complete digital amputation. DPA typically presents as a painless lesion or mass of the distal digits of the hands or feet. With the limited available literature regarding this malignancy, there is no standard approach to treatment. Wide excisional margins with sentinel lymph node mapping and biopsy are based on extrapolation for other tumors. In the following report, we discuss a representative case and the current literature on the presentation, treatment and pathology of this rare neoplasm.

Keywords

Digital papillary adenocarcinoma / Skin adnexal cancer

References

[1] Helwig EB. Eccrine acrospiroma. J Cutaneous Pathol. 1984; 11: 415. https://doi.org/10.1111/j.1600-0560.1984.tb00398.x

[2] Carter K, Yao JJ, Melton SD, et al. Digital papillary adenocarcinoma: Presentation, natural history and management. Rare Tumors. 2015; 7: 92-95. PMid: 26266016. https://doi.org/10.4081/rt.2015.5867

[3] Laun J, Gopman J, Barnes CW, et al. Aggressive digital papillary adenocarcinoma. Eplasty. 2015; 15: ic60. PMid: 26576210.

[4] Kao GF, Helwig EB, Graham JH. Aggressive digital papillary adenoma and adenocarcinoma. J Cutaneous Pathol. 1987; 14: 129-146. https://doi.org/10.1111/j.1600-0560.1987.tb00488.x

[5] Inaloz HS, Patel GK, Knight AG. An aggressive treatment for aggressive digital papillary adenocarcinoma. Cutis. 2002; 69: 179-82. PMid: 11926336.

[6] Suchak R, et al. Cutaneous digital papillary adenocarcinoma: A clinicopathologic study of 31 cases of a rare neoplasm with new observations. Am J Surgl Path. 2012; 36: 1883-1891. PMid: 23026931. https://doi.org/10.1097/PAS.0b013e31826320ec

[7] Duke WH, Sherrod TT, Lupton GP. Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). Am J Surg Pathol. 2000; 24(6): 775-84. PMid: 10843279. https://doi.org/10.1097/00000478-200006000-00002

[8] Lim S, Cho I, Lee MJ. Digital papillary carcinoma. Korean J Pathol. 2014; 48: 438-441. PMid: 25588636. https://doi.org/10.4132/KoreanJPathol.2014.48.6.438

[9] Heo EP, Kim CY, Oh CW. A case of aggressive digital papillary adenoma. Korean J Dermatol. 2002; 40: 811-5.

[10] Ivan D, Hafeez Diwan A, Prieto VG. Expression of p 63 in primary cutaneous adnexal neoplasms and adenocarcinoma metastatic to the skin. Mod Pathol. 2005 Jan; 18(1): 137-42. PMid: 15389254. https://doi.org/10.1038/modpathol.3800263

[11] Qureshi HS, Ormsby AH, Lee MW, et al. The diagnostic utility of p63, CK5/6, CK 7, and CK 20 in distinguishing primary cutaneous adnexal neoplasms from metastatic carcinomas. J Cutan Pathol. 2004; 31: 145-52. PMid: 14690459. https://doi.org/10.1111/j.0303-6987.2004.00147.x