Digital papillary adenocarcinoma

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

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

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/.