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A slowly enlarging mass on the finger
Julie Jefferson1, Curtis Thompson, Phoebe Rich
1Johns Hopkins Medicine. julieajeffersonmd@gmail.com.
Dermatology Online Journal
|March 12, 2014
Summary
A rare finger tumor, aggressive digital papillary adenocarcinoma (ADPAca), was diagnosed in a 71-year-old woman. Early surgical intervention is crucial due to its high metastatic potential.
Area of Science:
- Dermatopathology
- Surgical Oncology
Background:
- Adnexal tumors represent a diverse group of neoplasms originating from hair follicles or sebaceous glands.
- Aggressive digital papillary adenocarcinoma (ADPAca) is a rare adnexal tumor with a propensity for local recurrence and distant metastasis.
Observation:
- A 71-year-old woman presented with a slowly enlarging, asymptomatic 9-mm papule on her right 4th finger.
- Physical examination revealed a tan-pink, mobile papule with a central keratotic plug over the proximal interphalangeal joint.
Findings:
- Histopathologic examination of a punch biopsy confirmed the diagnosis of aggressive digital papillary adenocarcinoma (ADPAca).
- The tumor's rarity and nonspecific clinical presentation contribute to frequent misdiagnosis.
Implications:
- Aggressive digital papillary adenocarcinoma (ADPAca) requires prompt and radical surgical management, potentially including digital amputation.
- Sentinel lymph node biopsy may be considered in the management of ADPAca to assess for metastatic spread.
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