Aggressive digital papillary adenocarcinoma presenting as finger infection

Aggressive digital papillary adenocarcinoma (ADPA) is a rare tumor of sweat gland origin that may present in a nonspecific manner on the finger. The authors report a case of ADPA that was treated initially as a chronic infection of the finger, leading to a delay in diagnosis and definitive treatment. Failure of the wound to heal led to a biopsy of the lesion, which revealed ADPA. Because of the potential for aggressive local growth and distant metastases, amputation was indicated. This case demonstrates the importance of considering ADPA in the differential diagnosis of nonhealing wounds of the finger that have not responded to other forms of treatment. Wide local excision with clear margins and close surveillance for signs of recurrence or metastasis are indicated for this rare sweat gland neoplasm.