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Aggressive Digital Papillary Adenocarcinoma.

Laun J, Gopman J, Barnes CW, Segars KA, Elston JB, Stone J - Eplasty (2015)

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa.

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Pathology stains confirmed primary aggressive digital papillary adenocarcinoma (ADPA)... First described in 1979 as an “eccrine acrospiroma,” it was later described as an “aggressive digital papillary adenocarcinoma. ” ADPA mainly occurs in men 50 to 70 years old and arises from sweat glands... Figure 2 demonstrates the myriad of stains used to distinguish an ADPA from metastatic adenocarcinomas by looking at adnexal markers as well as those characteristic of lung and thyroid carcinomas... Treatment of ADPA is wide surgical excision with possible partial or complete amputation of the digit involved, although what adequate margins constitute are not firmly described... Adjuvant chemotherapy may be initiated in this population of patients despite overall poor responses... In the original study by Duke et al, it was found that only 5% of tumors recurred with surgical reexcision or amputation of the digit within 6 months, compared with 50% recurrence rate if not adequately reexcised... Metastasis rate has been estimated around 14% in patients with ADPA; therefore, there should be close follow-up with yearly chest radiographs looking for metastases, as 71% are found in the lung... Those found to have metastatic lesions died approximately 5 to 20 years after original diagnosis, indicating the range of possible outcomes... ADPAs are a very rare form of primary cancer found in the hand... As previous studies have not been able to establish the efficacy of adjuvant therapy, surgical excision with possible amputation remains the principle treatment option... Despite favorable recurrence rates after excision, patients with ADPA need to be followed closely, as the metastasis rate is significant and can occur many years after surgery.

No MeSH data available.


Related in: MedlinePlus

Gross specimen of left long finger mass after resection.
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Figure 1: Gross specimen of left long finger mass after resection.

Mentions: A 54-year-old man presented with a 7-year history of left long finger distal interphalangeal joint region mass. He underwent mass excision, and pathology demonstrated adenocarcinoma (Fig 1). The patient subsequently underwent an extensive oncological workup without identification of known primary source. Pathology stains confirmed primary aggressive digital papillary adenocarcinoma (ADPA).


Aggressive Digital Papillary Adenocarcinoma.

Laun J, Gopman J, Barnes CW, Segars KA, Elston JB, Stone J - Eplasty (2015)

Gross specimen of left long finger mass after resection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644354&req=5

Figure 1: Gross specimen of left long finger mass after resection.
Mentions: A 54-year-old man presented with a 7-year history of left long finger distal interphalangeal joint region mass. He underwent mass excision, and pathology demonstrated adenocarcinoma (Fig 1). The patient subsequently underwent an extensive oncological workup without identification of known primary source. Pathology stains confirmed primary aggressive digital papillary adenocarcinoma (ADPA).

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Pathology stains confirmed primary aggressive digital papillary adenocarcinoma (ADPA)... First described in 1979 as an “eccrine acrospiroma,” it was later described as an “aggressive digital papillary adenocarcinoma. ” ADPA mainly occurs in men 50 to 70 years old and arises from sweat glands... Figure 2 demonstrates the myriad of stains used to distinguish an ADPA from metastatic adenocarcinomas by looking at adnexal markers as well as those characteristic of lung and thyroid carcinomas... Treatment of ADPA is wide surgical excision with possible partial or complete amputation of the digit involved, although what adequate margins constitute are not firmly described... Adjuvant chemotherapy may be initiated in this population of patients despite overall poor responses... In the original study by Duke et al, it was found that only 5% of tumors recurred with surgical reexcision or amputation of the digit within 6 months, compared with 50% recurrence rate if not adequately reexcised... Metastasis rate has been estimated around 14% in patients with ADPA; therefore, there should be close follow-up with yearly chest radiographs looking for metastases, as 71% are found in the lung... Those found to have metastatic lesions died approximately 5 to 20 years after original diagnosis, indicating the range of possible outcomes... ADPAs are a very rare form of primary cancer found in the hand... As previous studies have not been able to establish the efficacy of adjuvant therapy, surgical excision with possible amputation remains the principle treatment option... Despite favorable recurrence rates after excision, patients with ADPA need to be followed closely, as the metastasis rate is significant and can occur many years after surgery.

No MeSH data available.


Related in: MedlinePlus