View source for Digital papillary adenocarcinoma

{{ Infobox diagnosis
| Name       = {{PAGENAME}}
| Image      = 
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| Caption    = 
| Synonyms   = aggressive digital papillary adenocarcinoma
| Micro      =
| Subtypes   =
| LMDDx      = [[basal cell carcinoma]], other basaloid tumours
| Stains     =
| IHC        = pankeratin +ve, CEA +ve (edge of ducts/spaces), EMA +ve (edge of ducts/spaces), S-100 +ve (luminal cells), SMA +ve (outer myoepithelial cell layer), p63 +ve (outer myoepithelial cell layer)
| EM         =
| Molecular  =
| IF         =
| Gross      =
| Grossing   =
| Site       = [[skin]] - digits (fingers or toes)
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms   =
| Prevalence = very rare
| Bloodwork  =
| Rads       =
| Endoscopy  =
| Prognosis  = aggressive
| Other      =
| ClinDDx    =
| Tx         = ampuation
}}
'''Digital papillary adenocarcinoma''' (abbreviated '''DPA'''), also '''aggressive digital papillary adenocarcinoma''' (abbreviated '''ADPA'''), is a rare [[malignant]] [[skin]] tumour.<ref name=pmid23026931>{{cite journal |author=Suchak R, Wang WL, Prieto VG, ''et al.'' |title=Cutaneous digital papillary adenocarcinoma: a clinicopathologic study of 31 cases of a rare neoplasm with new observations |journal=Am. J. Surg. Pathol. |volume=36 |issue=12 |pages=1883–91 |year=2012 |month=December |pmid=23026931 |doi=10.1097/PAS.0b013e31826320ec |url=}}</ref> 

==General==
*Very rare.
*Aggressive - amputation is typically recommended.<ref>{{cite journal |author=Hsu HC, Ho CY, Chen CH, Yang CH, Hong HS, Chuang YH |title=Aggressive digital papillary adenocarcinoma: a review |journal=Clin. Exp. Dermatol. |volume=35 |issue=2 |pages=113–9 |year=2010 |month=March |pmid=19874325 |doi=10.1111/j.1365-2230.2009.03490.x |url=}}</ref>
*Typically males 50-80 years old.
**May be seen in adolescents.<ref>{{cite journal |author=Frey J, Shimek C, Woodmansee C, ''et al.'' |title=Aggressive digital papillary adenocarcinoma: a report of two diseases and review of the literature |journal=J. Am. Acad. Dermatol. |volume=60 |issue=2 |pages=331–9 |year=2009 |month=February |pmid=18819728 |doi=10.1016/j.jaad.2008.07.038 |url=}}</ref>

==Gross==
*Distal end of a finger or toe.
**Usually fingers.<ref name=pmid23026931/>

==Microscopic==
Features:
*Papillary projections - very common, not required.
**Tubular structures.
*Basaloid cells usually with mild-to-moderate atypia.
*Fibrous stroma.<ref name=pmid24612571/>

DDx:
*[[Basal cell carcinoma]].
*[[Papillary eccrine adenoma]].
*Other basaloid tumours.

===Images===
*[http://www.indianjcancer.com/viewimage.asp?img=IndianJournalofCancer_2011_48_1_126_76641_u2.jpg ADPA (indianjcancer.com)].<ref name=pmid21330762>{{cite journal |author=Rastrelli M, Soteldo J, Vitali GC, ''et al.'' |title=Aggressive digital papillary adenocarcinoma |journal=Indian J Cancer |volume=48 |issue=1 |pages=126–7 |year=2011 |pmid=21330762 |doi=10.4103/0019-509X.76641 |url=}}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094519/figure/Fig3/ ADPA (nih.gov)].<ref>{{cite journal |author=Gole GN, Tati SY, Deshpande AK, Gole SG |title=Aggressive Digital Papillary Adenocarcinoma in a Young Female-a Rare Presentation |journal=J Hand Microsurg |volume=3 |issue=1 |pages=31–3 |year=2011 |month=June |pmid=22654416 |pmc=3094519 |doi=10.1007/s12593-010-0028-1 |url=}}</ref>
*[http://escholarship.org/uc/item/212957kk.pdf ADPA (escholarship.org)].<ref name=pmid24612571>{{cite journal |author=Jefferson J, Thompson C, Rich P |title=A slowly enlarging mass on the finger |journal=Dermatol. Online J. |volume=20 |issue=2 |pages= |year=2014 |month=February |pmid=24612571 |doi= |url=}}</ref>

==IHC==
Features:<ref name=pmid23026931/>
*Pankeratin +ve.
*CEA +ve (edge of ducts/spaces).
*EMA +ve (edge of ducts/spaces).
*S-100 +ve (luminal cells).
*SMA +ve (outer myoepithelial cell layer).
*p63 +ve (outer myoepithelial cell layer).

==See also==
*[[Dermatopathology]].

==References==
{{reflist|2}}

[[Category:Dermatopathology]]
[[Category:Diagnosis]]