Kempton Steve J, Navarrete Andrew D, Salyapongse A Neil
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, WI.
Ann Plast Surg. 2015 Jul;75(1):34-6. doi: 10.1097/SAP.0000000000000111.
Aggressive digital papillary adenocarcinoma (ADPA) is an uncommon eccrine sweat gland tumor of the distal extremities that is associated with a high rate of local recurrence and distant metastasis. Current opinion suggests that sentinel lymph node evaluation should be done for high-risk tumors where lymph node spread is a concern. Despite documented spread to regional lymph nodes, information on sentinel lymph node status in ADPA is reported infrequently, with only 1 documented case of positive findings. We report on a case of ADPA of the right long finger where sentinel lymph node biopsy was done and positive for metastases in the axilla, resulting in a subsequent completion lymphadenectomy. To determine the benefit of sentinel lymph node biopsy in ADPA, there is a need for more cases of sentinel lymph node evaluation along with data on local recurrence and distant metastasis in those with positive and negative findings.
侵袭性指状乳头状腺癌(ADPA)是一种罕见的发生于四肢远端的小汗腺肿瘤,与局部复发和远处转移的高发生率相关。目前的观点认为,对于存在淋巴结转移风险的高危肿瘤,应进行前哨淋巴结评估。尽管有文献记载ADPA可发生区域淋巴结转移,但关于ADPA前哨淋巴结状态的报道却很少,仅有1例阳性结果的记录。我们报告1例右手中指的ADPA病例,该病例进行了前哨淋巴结活检,结果显示腋窝转移阳性,随后进行了根治性淋巴结清扫术。为了确定前哨淋巴结活检在ADPA中的益处,需要更多前哨淋巴结评估的病例以及有关前哨淋巴结活检结果为阳性和阴性患者的局部复发和远处转移的数据。