Difference between revisions of "Digital papillary adenocarcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| Synonyms  = aggressive digital papillary adenocarcinoma
| Micro      =
| Subtypes  =
| LMDDx      = [[basal cell carcinoma]], other basaloid tumours
| Stains    =
| IHC        = pankeratin +ve, CEA +ve (edge of ducts/spaces), EMA +ve (edge of ducts/spaces), S-100 +ve (luminal cells), SMA +ve (outer myoepithelial cell layer), p63 +ve (outer myoepithelial cell layer)
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[skin]] - digits (fingers or toes)
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = aggressive
| Other      =
| ClinDDx    =
| Tx        = ampuation
}}
'''Digital papillary adenocarcinoma''' (abbreviated '''DPA'''), also '''aggressive digital papillary adenocarcinoma''' (abbreviated '''ADPA'''), is a rare [[malignant]] [[skin]] tumour.<ref name=pmid23026931>{{cite journal |author=Suchak R, Wang WL, Prieto VG, ''et al.'' |title=Cutaneous digital papillary adenocarcinoma: a clinicopathologic study of 31 cases of a rare neoplasm with new observations |journal=Am. J. Surg. Pathol. |volume=36 |issue=12 |pages=1883–91 |year=2012 |month=December |pmid=23026931 |doi=10.1097/PAS.0b013e31826320ec |url=}}</ref>  
'''Digital papillary adenocarcinoma''' (abbreviated '''DPA'''), also '''aggressive digital papillary adenocarcinoma''' (abbreviated '''ADPA'''), is a rare [[malignant]] [[skin]] tumour.<ref name=pmid23026931>{{cite journal |author=Suchak R, Wang WL, Prieto VG, ''et al.'' |title=Cutaneous digital papillary adenocarcinoma: a clinicopathologic study of 31 cases of a rare neoplasm with new observations |journal=Am. J. Surg. Pathol. |volume=36 |issue=12 |pages=1883–91 |year=2012 |month=December |pmid=23026931 |doi=10.1097/PAS.0b013e31826320ec |url=}}</ref>  


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*Very rare.
*Very rare.
*Aggressive - amputation is typically recommended.<ref>{{cite journal |author=Hsu HC, Ho CY, Chen CH, Yang CH, Hong HS, Chuang YH |title=Aggressive digital papillary adenocarcinoma: a review |journal=Clin. Exp. Dermatol. |volume=35 |issue=2 |pages=113–9 |year=2010 |month=March |pmid=19874325 |doi=10.1111/j.1365-2230.2009.03490.x |url=}}</ref>
*Aggressive - amputation is typically recommended.<ref>{{cite journal |author=Hsu HC, Ho CY, Chen CH, Yang CH, Hong HS, Chuang YH |title=Aggressive digital papillary adenocarcinoma: a review |journal=Clin. Exp. Dermatol. |volume=35 |issue=2 |pages=113–9 |year=2010 |month=March |pmid=19874325 |doi=10.1111/j.1365-2230.2009.03490.x |url=}}</ref>
*Typically males 50-70 years old.
*Typically males 50-80 years old.
**May be seen in adolescents.<ref>{{cite journal |author=Frey J, Shimek C, Woodmansee C, ''et al.'' |title=Aggressive digital papillary adenocarcinoma: a report of two diseases and review of the literature |journal=J. Am. Acad. Dermatol. |volume=60 |issue=2 |pages=331–9 |year=2009 |month=February |pmid=18819728 |doi=10.1016/j.jaad.2008.07.038 |url=}}</ref>
**May be seen in adolescents.<ref>{{cite journal |author=Frey J, Shimek C, Woodmansee C, ''et al.'' |title=Aggressive digital papillary adenocarcinoma: a report of two diseases and review of the literature |journal=J. Am. Acad. Dermatol. |volume=60 |issue=2 |pages=331–9 |year=2009 |month=February |pmid=18819728 |doi=10.1016/j.jaad.2008.07.038 |url=}}</ref>


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**Tubular structures.
**Tubular structures.
*Basaloid cells usually with mild-to-moderate atypia.
*Basaloid cells usually with mild-to-moderate atypia.
*Fibrous stroma.<ref name=pmid24612571/>


DDx:
DDx:
*[[Basal cell carcinoma]].
*[[Basal cell carcinoma]].
*[[Papillary eccrine adenoma]].
*Other basaloid tumours.
*Other basaloid tumours.


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*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094519/figure/Fig3/ ADPA (nih.gov)].<ref>{{cite journal |author=Gole GN, Tati SY, Deshpande AK, Gole SG |title=Aggressive Digital Papillary Adenocarcinoma in a Young Female-a Rare Presentation |journal=J Hand Microsurg |volume=3 |issue=1 |pages=31–3 |year=2011 |month=June |pmid=22654416 |pmc=3094519 |doi=10.1007/s12593-010-0028-1 |url=}}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094519/figure/Fig3/ ADPA (nih.gov)].<ref>{{cite journal |author=Gole GN, Tati SY, Deshpande AK, Gole SG |title=Aggressive Digital Papillary Adenocarcinoma in a Young Female-a Rare Presentation |journal=J Hand Microsurg |volume=3 |issue=1 |pages=31–3 |year=2011 |month=June |pmid=22654416 |pmc=3094519 |doi=10.1007/s12593-010-0028-1 |url=}}</ref>
*[http://escholarship.org/uc/item/212957kk.pdf ADPA (escholarship.org)].<ref name=pmid24612571>{{cite journal |author=Jefferson J, Thompson C, Rich P |title=A slowly enlarging mass on the finger |journal=Dermatol. Online J. |volume=20 |issue=2 |pages= |year=2014 |month=February |pmid=24612571 |doi= |url=}}</ref>
*[http://escholarship.org/uc/item/212957kk.pdf ADPA (escholarship.org)].<ref name=pmid24612571>{{cite journal |author=Jefferson J, Thompson C, Rich P |title=A slowly enlarging mass on the finger |journal=Dermatol. Online J. |volume=20 |issue=2 |pages= |year=2014 |month=February |pmid=24612571 |doi= |url=}}</ref>
==IHC==
Features:<ref name=pmid23026931/>
*Pankeratin +ve.
*CEA +ve (edge of ducts/spaces).
*EMA +ve (edge of ducts/spaces).
*S-100 +ve (luminal cells).
*SMA +ve (outer myoepithelial cell layer).
*p63 +ve (outer myoepithelial cell layer).
==See also==
==See also==
*[[Dermatopathology]].
*[[Dermatopathology]].

Latest revision as of 17:36, 27 June 2014

Digital papillary adenocarcinoma
Diagnosis in short
Synonyms aggressive digital papillary adenocarcinoma
LM DDx basal cell carcinoma, other basaloid tumours
IHC pankeratin +ve, CEA +ve (edge of ducts/spaces), EMA +ve (edge of ducts/spaces), S-100 +ve (luminal cells), SMA +ve (outer myoepithelial cell layer), p63 +ve (outer myoepithelial cell layer)
Site skin - digits (fingers or toes)
Prevalence very rare
Prognosis aggressive
Treatment ampuation

Digital papillary adenocarcinoma (abbreviated DPA), also aggressive digital papillary adenocarcinoma (abbreviated ADPA), is a rare malignant skin tumour.[1]

General

  • Very rare.
  • Aggressive - amputation is typically recommended.[2]
  • Typically males 50-80 years old.
    • May be seen in adolescents.[3]

Gross

  • Distal end of a finger or toe.
    • Usually fingers.[1]

Microscopic

Features:

  • Papillary projections - very common, not required.
    • Tubular structures.
  • Basaloid cells usually with mild-to-moderate atypia.
  • Fibrous stroma.[4]

DDx:

Images

IHC

Features:[1]

  • Pankeratin +ve.
  • CEA +ve (edge of ducts/spaces).
  • EMA +ve (edge of ducts/spaces).
  • S-100 +ve (luminal cells).
  • SMA +ve (outer myoepithelial cell layer).
  • p63 +ve (outer myoepithelial cell layer).

See also

References

  1. ↑ 1.0 1.1 1.2 Suchak R, Wang WL, Prieto VG, et al. (December 2012). "Cutaneous digital papillary adenocarcinoma: a clinicopathologic study of 31 cases of a rare neoplasm with new observations". Am. J. Surg. Pathol. 36 (12): 1883–91. doi:10.1097/PAS.0b013e31826320ec. PMID 23026931.
  2. ↑ Hsu HC, Ho CY, Chen CH, Yang CH, Hong HS, Chuang YH (March 2010). "Aggressive digital papillary adenocarcinoma: a review". Clin. Exp. Dermatol. 35 (2): 113–9. doi:10.1111/j.1365-2230.2009.03490.x. PMID 19874325.
  3. ↑ Frey J, Shimek C, Woodmansee C, et al. (February 2009). "Aggressive digital papillary adenocarcinoma: a report of two diseases and review of the literature". J. Am. Acad. Dermatol. 60 (2): 331–9. doi:10.1016/j.jaad.2008.07.038. PMID 18819728.
  4. ↑ 4.0 4.1 Jefferson J, Thompson C, Rich P (February 2014). "A slowly enlarging mass on the finger". Dermatol. Online J. 20 (2). PMID 24612571.
  5. ↑ Rastrelli M, Soteldo J, Vitali GC, et al. (2011). "Aggressive digital papillary adenocarcinoma". Indian J Cancer 48 (1): 126–7. doi:10.4103/0019-509X.76641. PMID 21330762.
  6. ↑ Gole GN, Tati SY, Deshpande AK, Gole SG (June 2011). "Aggressive Digital Papillary Adenocarcinoma in a Young Female-a Rare Presentation". J Hand Microsurg 3 (1): 31–3. doi:10.1007/s12593-010-0028-1. PMC 3094519. PMID 22654416. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094519/.
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