Aggressive digital papillary adenocarcinoma is a slow growing, painless malignant sweat gland tumour. It is a rare life-threatening malignant tumour and the diagnosis is easily missed or delayed. Both clinician and pathologist should keep this rare condition in mind when dealing with tumours of the digits.
It is usually located on the fingers. The tumour enlarges over several years. Patients are usually elderly male (50 -70 year old). The clinical presentation is often confusing and can be easily misdiagnosed for a benign lesion such as a ganglion cyst, pyogenic granuloma, or soft-tissue infection.
Microscopic diagnosis is also challenging and it can be wrongly diagnosed as a metastatic papillary adenocarcinoma originating in the colon, thyroid, or breast. Clinicopathological correlation is essential to rule out a possible risk of metastatic carcinoma of the skin.
These are aggressive lesions which can often recur, metastasize to distant sites, and invade local tissues including bone.
Aggressive treatment like amputation of the finger is recommended for this aggressive tumour.