Aggressive Digital Papillary Adenocarcinoma: A Rare Diagnostic Challenge
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Aggressive Digital Papillary Adenocarcinoma–A rare Entity Posing a Diagnostic Challenge
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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V Geethamani, Archana SHETTY, Vijaya CHIWDAPPA
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Aggressive Digital Papillary Adenocarcinoma–A rare Entity Posing a Diagnostic Challenge
Year: 2014
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Aggressive digital papillary adenocarcinoma (ADPCA) is a rare and distinct malignant tumor of the sweat glands, primarily characterized by lesions on the fingers, toes, and digits. Due to its similarity to benign conditions such as pyogenic granuloma, ADPCA is often misdiagnosed, leading to significant delays in appropriate treatment. This malignancy has the potential for recurrence and metastasis, necessitating a high degree of clinical suspicion for effective diagnosis and intervention.
Importance of Early Diagnosis
A case study presented a 40-year-old woman who initially exhibited a skin-colored nodule on her finger, suspected to be a benign condition. However, subsequent histopathological examinations revealed a malignant sweat gland tumor. Despite early surgical intervention, the patient experienced recurrence with aggressive growth, leading to distal phalanx amputation after imaging indicated tumor involvement with nearby structures. The thorough examination of histological features confirmed the diagnosis of ADPCA and highlighted the aggressive nature of the tumor, underscoring the importance of differentiating it from similar benign entities to ensure timely and definitive treatment.
Conclusion
ADPCA remains an uncommon but serious entity that can easily masquerade as benign lesions, thereby risking delayed diagnoses and inadequate treatment. Its potential for aggressive local growth and metastasis accentuates the necessity for vigilance among clinicians. Recognizing the histological characteristics and adhering to appropriate treatment protocols, such as surgical amputation for definitive management, are crucial in improving patient outcomes. Long-term follow-up is essential to monitor for possible recurrence or metastasis, emphasizing the need for ongoing awareness of this rare condition’s clinical behavior.
FAQ section (important questions/answers):
What is aggressive digital papillary adenocarcinoma (ADPCA)?
ADPCA is a rare malignant tumor originating from sweat glands, typically presenting as lesions on fingers and toes. It is often misdiagnosed as benign conditions, leading to delays in appropriate treatment.
How can ADPCA be clinically identified?
Clinically, ADPCA can be mistaken for benign lesions like pyogenic granuloma or ganglion cysts. It usually manifests as a solitary, dome-shaped nodule, requiring careful examination for accurate diagnosis.
What treatment options are available for ADPCA?
Treatment typically involves surgical excision or amputation, given the high recurrence rates. Full body imaging may also be performed to check for metastasis, especially if the tumor has reoccurred or is aggressive.
What are the histopathological features of ADPCA?
Histologically, ADPCA displays varied patterns including large cystic spaces with tumor cells. These cells show moderate pleomorphism, brisk mitotic activity, and may also demonstrate positivity for epithelial and myoepithelial markers in immunohistochemical tests.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Aggressive Digital Papillary Adenocarcinoma: A Rare Diagnostic Challenge”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Hand:
The term 'hand' is relevant as it refers to the site where aggressive digital papillary adenocarcinoma (ADPCA) commonly occurs. The hand is part of the anatomy most affected by this disease, leading to clinical challenges in distinguishing the malignant lesions from benign conditions, thus stressing the importance of careful evaluation.
2) Sweating (Sweat):
The term 'sweat' relates to the type of glands from which aggressive digital papillary adenocarcinoma arises. As a sweat gland tumor, understanding its association with sweat production helps in comprehending the tumor's biological behavior, pathology, and potential symptoms, emphasizing the need for appropriate clinical assessments in affected areas.
3) Study (Studying):
The word 'study' captures the context of research and examination of ADPCA in the case presented. It underscores the scientific inquiry involved in diagnosing this rare condition, analyzing its clinical features, treatment modalities, and histopathological characteristics, thereby aiding in medical education and improving awareness among healthcare professionals.
4) Cancer:
The term 'cancer' is central to the discussion of aggressive digital papillary adenocarcinoma, a malignant neoplasm. Understanding cancer encompasses various aspects, including its biology, progression, treatment options, and patient management strategies, which are critical for physicians in making informed decisions about patient care and improving outcomes.
5) Swelling:
Swelling refers to the physical manifestation of aggressive digital papillary adenocarcinoma, often noted as a dome-shaped nodule in patients. This term is essential in the clinical assessment process, as it helps doctors identify and raise suspicion for malignancy, especially when the swelling is often confused with benign conditions.
6) Table:
The term 'table' can refer to the presentation of histopathological data in an organized manner. While not mentioned directly, tables serve as essential tools in studies to summarize findings regarding tumor characteristics, such as cell types and mitotic activity, thereby aiding in clearer understanding and communication of complex data.
7) Activity:
The word 'activity' relates to mitotic activity often discussed in the context of cancer pathology. High mitotic activity is indicative of aggressive tumor behavior and helps pathologists assess the malignancy grade, guiding treatment decisions and follow-up strategies in aggressive digital papillary adenocarcinoma cases.
8) Cutan:
The term 'Cutan' refers to the skin, as the context of this study involves a cutaneous tumor. Recognizing it as a skin-related condition emphasizes the need for dermatologists and oncologists to accurately diagnose and treat skin cancers like ADPCA, enhancing the understanding of skin tumor origins and implications.
9) Tati:
The term 'Tati' likely refers to one of the authors, emphasizing the collaborative nature of medical research. The contributions of varied professionals strengthen the reliability of findings, foster comprehensive perspectives in studies, and promote advancements in understanding rare tumors like ADPCA, and their clinical presentations.
10) Surrounding:
The word 'surrounding' refers to the tissue around the tumor, which is critical in assessing the invasiveness of aggressive digital papillary adenocarcinoma. Evaluating surrounding tissues can offer insights into tumor behavior, help determine surgical margins, and inform clinical decisions regarding treatment and prognosis.
11) Discussion:
The term 'discussion' represents an essential segment of the research where findings are analyzed, compared with existing literature, and interpreted. This element serves to frame the implications of the study, addressing clinical relevance, shortcomings, and proposing future research directions regarding aggressive digital papillary adenocarcinoma.
12) Disease:
The term 'disease' encapsulates the pathological state caused by aggressive digital papillary adenocarcinoma. It stresses the importance of understanding its epidemiology, clinical manifestations, and potential treatment approaches, reinforcing the need for heightened awareness and prompt medical intervention to improve patient outcomes.
13) Dealing:
The word 'dealing' refers to the approach healthcare professionals take when managing cases of aggressive digital papillary adenocarcinoma. It highlights the significance of understanding differential diagnoses and developing effective treatment strategies, thus better equipping clinicians to handle such complex and challenging cases.
14) Nature:
The term 'nature' often refers to inherent qualities or characteristics, especially concerning tumor behavior. In the case of ADPCA, understanding its aggressive nature is crucial for diagnosis and treatment, guiding clinicians toward appropriate surveillance strategies to manage potential metastasis and recurrence effectively.
15) Arrow:
The word 'arrow' is used to illustrate key findings in histopathological figures, signifying the location of tumor presence within tissue samples. This visual aid is essential for pathologists, enhancing clarity in analysis and aiding in accurate diagnosis and communication of findings to clinical colleagues.
16) Sign:
The term 'sign' is relevant in the context of clinical examination, indicating visual or physical manifestations of disease. In diagnosing aggressive digital papillary adenocarcinoma, recognizing various signs is vital for healthcare providers to make informed decisions about further testing and treatment options.
17) Pain:
The word 'pain' refers to the symptom associated with aggressive digital papillary adenocarcinoma, highlighting the patient’s experience. Documenting patient-reported symptoms is crucial in understanding how the disease affects quality of life and can guide treatment decisions and supportive care measures.
18) Post:
The term 'post' relates to postoperative care and follow-up after the amputation of the affected digit. Understanding post-surgical management is critical for minimizing complications and monitoring for recurrence of aggressive digital papillary adenocarcinoma, ultimately ensuring better long-term patient outcomes.
19) Male:
The word 'male' references demographic information about the prevalence of aggressive digital papillary adenocarcinoma in the patient population. Although cases in females exist, acknowledging this tendency could inform future studies and treatment approaches, emphasizing the need for tailored interventions in affected genders.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Aggressive Digital Papillary Adenocarcinoma: A Rare Diagnostic Challenge’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Amputation, Long-term follow-up, Recurrence, Histopathological examination, Magnetic resonance imaging, Malignant tumor, Metastasis, Computed tomography, Tumor, Dermis, Wide excision, Tumor cell, Benign lesion, High index of suspicion, Pyogenic granuloma, Immunohistochemistry, Epithelial origin, Malignant neoplasm, Distant metastasis, Primary tumor, Soft tissue, Sweat gland tumors, Histopathological features, Recurrence and metastasis, Soft tissue growth, Papillary projection, Eosinophilic cytoplasm, Surgical margin, Clinicopathological findings, Local excision, Distal phalanx, Epithelial markers, Vesicular nuclei, Index of suspicion.