Digital Papillary Adenocarcinoma: Presentation, Natural History and Management

Abstract

Digital papillary adenocarcinoma (DPA) is a rare malignant tumor of the sweat glands that often presents as a solitary painless mass on the digits of the hands or feet. We present a rare case of DPA on the ankle in a 54 year-old African American man. Although the most common location for digital papillary adenocarcinoma is on the hands and feet, it can present in other locations. Treatment modalities and concerns such as the level of margin resection, degree of negative margins, and the need for a sentinel lymph node biopsy might be different if the tumor is encountered in locations other than the digits. In the following manuscript, we discuss the natural history of this rare tumor including a review of the current literature with emphasis on documented treatment strategies as well as the approach in treating patients with a unique presentation.

Keywords: Surgery; adenocarcinoma; neoplasia; oncology; rare diseases; tumors.

Figure 1.

The histologic findings (Hematoxylin & Eosin).

Figure 2.

Positron emission tomography images demonstrating a focus of intense activity in the right iliopsoas muscle neighboring the right femoral neck.