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Aggressive Digital Papillary Adenocarcinoma-A rare Entity Posing a Diagnostic Challenge
V Geethamani1, Archana Shetty1, Vijaya Chiwdappa1
1Sapthagiri Institute of Medical Sciences and Research Center Hesaraghatta Main Road, Channasanrda PIN 560090, Karnataka, India.
The Malaysian Journal of Medical Sciences : MJMS
|May 16, 2015
Summary
Aggressive digital papillary adenocarcinoma (ADPCA), a rare sweat gland tumor, presents as digit lesions often misdiagnosed. This case highlights the need for high suspicion due to its rarity and potential for misdiagnosis.
Area of Science:
- Dermatopathology
- Oncology
- Surgical Pathology
Background:
- Aggressive digital papillary adenocarcinoma (ADPCA) is a rare malignant tumor originating from sweat glands.
- ADPCA typically affects the digits (fingers and toes) and can be clinically mistaken for benign conditions.
- Early and accurate diagnosis is crucial due to the serious nature of the tumor.
Purpose of the Study:
- To present a case of ADPCA in a 40-year-old female patient.
- To emphasize the diagnostic challenges and the importance of a high index of suspicion for ADPCA.
- To contribute to the limited literature on this rare malignancy.
Main Methods:
- Clinical presentation and initial misdiagnosis as pyogenic granuloma.
- Excision biopsy confirming a malignant sweat gland tumor.
- Histopathological examination with marker studies.
- Ray amputation of the affected digit followed by metastasis workup.
Main Results:
- Histopathological analysis confirmed ADPCA.
- The patient underwent Ray amputation for definitive treatment.
- Comprehensive workup was performed to exclude metastasis.
Conclusions:
- ADPCA requires a high index of suspicion, especially for lesions on the digits.
- Clinical misdiagnosis is common, underscoring the need for thorough histopathological evaluation.
- Further documentation and awareness are necessary for improved patient outcomes.
