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Metastatic aggressive digital papillary adenocarcinoma
Coleman E Altman1, Randy L Hamill, Dirk M Elston
1Department of Dermatology, Brooke Army Medical Center, Building 3600, San Antonio, TX 78234, USA. coleman.altman@amedd.army.mil
Cutis
|September 5, 2003
Summary
Aggressive digital papillary adenocarcinoma, a rare sweat gland cancer, can metastasize. Ferritin antibody shows promise as a diagnostic marker for this acral tumor and its adenoma precursor.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Aggressive digital papillary adenocarcinoma (ADPAca) is a rare malignancy originating from sweat glands, typically affecting the digits.
- Metastatic spread of acral tumors can present with complex cystic masses, potentially leading to diagnostic challenges.
Observation:
- A 52-year-old male presented with asymptomatic cystic masses in the inguinal region.
- Histopathologic examination revealed the inguinal masses as metastatic disease.
- The primary tumor, located between the third and fourth metatarsal heads, was diagnosed as aggressive digital papillary adenocarcinoma (ADPAca).
Findings:
- The primary acral tumor demonstrated focal positivity for ferritin antibody.
- Ferritin antibody is an immunohistologic marker associated with sweat gland malignancies.
- The metastatic cystic masses in the inguinal region correlated with the primary acral adenocarcinoma.
Implications:
- Ferritin antibody immunoreactivity may aid in diagnosing aggressive digital papillary adenoma (ADPA) and ADPAca.
- This case highlights the metastatic potential of acral tumors.
- Accurate diagnosis of primary acral malignancies is crucial for effective treatment and management of metastatic disease.