A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy

A rare case report of Aggressive Digital Adenocarcinoma (ADPCa) is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC), marjolin’s ulceration/squamous cell carcinoma (MSCC) and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

[1]  J. Plastaras,et al.  Diffusely metastatic digital papillary adenocarcinoma 11 years after initial presentation treated with palliative chemotherapy and radiotherapy. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  S. Pavlovic,et al.  Marjolin's ulcer of the hallux. , 2013, Journal of the American Podiatric Medical Association.

[3]  A. Lazar,et al.  Cutaneous Digital Papillary Adenocarcinoma: A Clinicopathologic Study of 31 Cases of a Rare Neoplasm With New Observations , 2012, The American journal of surgical pathology.

[4]  C. Fife,et al.  Using a diagnostic tool to identify elevated protease activity levels in chronic and stalled wounds: a consensus panel discussion. , 2011, Ostomy/wound management.

[5]  Stacie L Buck,et al.  A Comprehensive Review on Marjolin's Ulcers: Diagnosis and Treatment. , 2011, The journal of the American College of Certified Wound Specialists.

[6]  J. Garcia‐Zuazaga,et al.  Basal cell carcinoma: evidence‐based medicine and review of treatment modalities , 2011, International journal of dermatology.

[7]  H. Hong,et al.  Aggressive digital papillary adenocarcinoma: a review , 2010, Clinical and experimental dermatology.

[8]  A. Shahla.  An overview of heel Marjolin's ulcers in the Orthopedic Department of Urmia University of Medical Sciences. , 2009, Archives of Iranian medicine.

[9]  K. Katsuoka,et al.  Aggressive digital papillary adenocarcinoma on the palm with pulmonary metastases , 2008, The Journal of dermatology.

[10]  D. Ghazarian,et al.  Skin adnexal neoplasms—part 2: An approach to tumours of cutaneous sweat glands , 2006, Journal of Clinical Pathology.

[11]  S. Schnall,et al.  Marjolin’s Ulcer Arising at the Elbow: A Case Report and Literature Review , 2006, Hand.

[12]  W. Sterry.  Guidelines: the management of basal cell carcinoma. , 2006, European journal of dermatology : EJD.

[13]  M. Levy.  Dermatology for Plastic Surgeons , 2006 .

[14]  K. Revelos,et al.  Aggressive digital papillary adenoma-adenocarcinoma , 2006, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[15]  R. Matkowski,et al.  Marjolin's ulcer: malignant neoplasm arising in scars , 2006 .

[16]  D. Elston,et al.  Metastatic aggressive digital papillary adenocarcinoma. , 2003, Cutis.

[17]  V. Sondak,et al.  Lymphatic mapping and sentinel lymph node biopsy in the detection of early metastasis from sweat gland carcinoma , 2003, Cancer.

[18]  K. Kiuchi,et al.  p63 expression in normal human epidermis and epidermal appendages and their tumors , 2003, Journal of cutaneous pathology.

[19]  M. Kripke,et al.  Mechanisms underlying the suppression of established immune responses by ultraviolet radiation. , 2002, The Journal of investigative dermatology.

[20]  C. Cordon-Cardo,et al.  p63 expression profiles in human normal and tumor tissues. , 2002, Clinical cancer research : an official journal of the American Association for Cancer Research.

[21]  D. Kuijpers,et al.  Basal Cell Carcinoma , 2002, American journal of clinical dermatology.

[22]  J. Seykora,et al.  Aggressive digital papillary adenocarcinoma: a case report and review of the literature. , 2001, The American Journal of dermatopathology.

[23]  R. Stern,et al.  Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. , 2000, Archives of dermatology.

[24]  C. Antonescu,et al.  Aggressive digital papillary adenocarcinoma of the foot: the clinicopathologic features of two cases. , 2000, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[25]  P. Leboit,et al.  Microcystic adnexal carcinoma with extensive sebaceous differentiation. , 1997, The American Journal of dermatopathology.

[26]  J. Feyzi,et al.  Metastatic basal cell carcinoma. Report of five cases , 1994, Cancer.

[27]  Charles H. Thorne,et al.  Grabb and Smith's Plastic Surgery , 1991 .

[28]  M. Fleming,et al.  Marjolin's ulcer: a review and reevaluation of a difficult problem. , 1990, The Journal of burn care & rehabilitation.

[29]  N. Penneys,et al.  Aggressive digital papillary adenocarcinoma. , 1990, Journal of the American Academy of Dermatology.

[30]  E. B. Helwig,et al.  Aggressive digital papillary adenoma and adenocarcinoma. A clinicopathological study of 57 patients, with histochemical, immunopathological, and ultrastructural observations , 1987, Journal of cutaneous pathology.

[31]  M. Stone,et al.  Squamous cell carcinoma of the hallux. , 1982, The Journal of foot surgery.