Dege Tassilo, Rütten Arno, Goebeler Matthias, Kneitz Hermann
Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany.
Dermatopathology Friedrichshafen, 88048 Friedrichshafen, Germany.
Dermatopathology (Basel). 2024 Dec 9;11(4):348-353. doi: 10.3390/dermatopathology11040037.
Digital papillary adenocarcinoma (DPAC) is a rare, low-grade sweat gland carcinoma primarily found on the hands, fingers, or toes and predominantly affecting males. Distinguishing DPAC from benign sweat gland tumors can be challenging. We present the case of a 52-year-old patient with a progressive tumor on the finger initially misdiagnosed as a viral wart. Histological examination revealed a cytologically basophilic sweat gland tumor with tubular structures, papillary protrusions, and a characteristic immunohistochemical staining pattern for CK 7 and Actin. HPV-42 positivity and molecular analysis confirmed the diagnosis of DPAC. HPV-42 has been strongly associated with DPAC. Additionally, p16 positivity and BRAFV600E negativity were observed. These findings aid in the differential diagnosis of acral sweat gland tumors and guide clinical management, including with respect to the potential for recurrence and metastasis.
指状乳头状腺癌（DPAC）是一种罕见的低级别汗腺癌，主要发生于手部、手指或脚趾，且男性更为多见。将DPAC与良性汗腺肿瘤区分开来可能具有挑战性。我们报告一例52岁患者，其手指上有一进行性肿瘤，最初被误诊为病毒疣。组织学检查显示为一种细胞嗜碱性的汗腺肿瘤，具有管状结构、乳头状突起以及CK 7和肌动蛋白特征性免疫组化染色模式。HPV - 42阳性及分子分析确诊为DPAC。HPV - 42与DPAC密切相关。此外，观察到p16阳性和BRAFV600E阴性。这些发现有助于肢端汗腺肿瘤的鉴别诊断，并指导临床管理，包括复发和转移的可能性。
