Adenoma aggressive digital papillary D23.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Semimalignant adnexal tumor with apocrine (eccrine) differentiation, which tends to infiltrate local growth and local recurrence. There is a smooth transition to an aggressive papillary adenocarcinoma of the finger.

Manifestation
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In adults of all ages; men are more frequently affected than women.

Localization
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Fingers, toes, soles of the feet and palms of the hands.

Clinical features
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Solitary occurring, clinically little distinct, up to 2 cm large, skin-coloured, symptomless lump.

Histology
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Non-encapsulated, solid, tubular and papillary complexes with different sized eosinophilic necrosis islets in some tubules. The tumor cells have hyperchromatic nuclei and a relatively narrow cytoplasm. Broad hyalinized connective tissue stroma. Mitotic figures are common.

Complication(s)
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Local aggressive growth with infiltration of underlying bone structures. Haematogenic metastasis has been described in individual cases.

Therapy
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Complete excision using microscopically controlled surgery is absolutely necessary. Therapy by experienced hand surgeons!

Note(s)
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Clinically and histologically smooth transition to adenocarcinoma!

Literature
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  1. Digeler A et al (2003) Aggressive digital papillary adenocarcinoma - case report. Handchir Microchir Plast Chir 34: 137-139
  2. Duke WH et al (2000) Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). On J Surg Path 24: 775-784
  3. Inaloz HS et al (2003) An aggressive treatment for aggressive digital papillary adenocarcinoma. Cutis 69: 179-182
  4. Kurtz DH et al (2000) Papillary eccrine adenoma of the heel: a case report. J Foot Ankle Surgery 39: 249-252
  5. Mandys V et al (1997) Aggressive papillary adenoma of a digit. Cesk Patol 33: 132-136
  6. Tellechea O et al (1995) Tubular apocrine adenoma with eccrine and apocrine immunophenotypes or papillary tubular adenoma? At J Dermatopathol 17: 499-505

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Last updated on: 29.10.2020