Digital papillary adenocarcinoma

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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. //www.ncbi.nlm.nih.gov/pmc/articles/PMC3094519/.