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Swati Baveja



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    P3.CR - Case Reports (Not CME Accredited Session) (ID 984)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.CR-23 - Multilobar Adenocarcinoma: A Case Report and Review of the Literature of Papillary Eccrine Adenocarcinoma Presenting with Respiratory Failure. (ID 13494)

      12:00 - 13:30  |  Author(s): Swati Baveja

      • Abstract
      • Slides

      Background

      Aggressive digital papillary adenocarcinoma (ADPAca) is a rarely recognized neoplasm of the sweat gland duct that has a high metastatic potential with metastasis seen in the lymph nodes, liver, lungs, and bones. Originally described in 1865, this tumor represents a rare group of sweat gland carcinomas. We report the uncommon presentation of a patient with metastatic eccrine adenocarcinoma and hypoxic respiratory failure with a review of the literature.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A 52-year-old Caucasian male was brought to the emergency room by his wife appearing cyanotic and with a saturation of 82%. The respiratory exam demonstrated coarse breath sounds and a well-healed right thoracotomy scar. His extremities demonstrated a prior amputation of the second finger of the left hand. He was subsequently intubated and imaging obtained (Fig. 1).
      The wife noted he had a slowly growing lesion on the left second finger approximately 10 years before initial presentation with primary amputation and a diagnosis of papillary eccrine adenocarcinoma. Concurrently, a right upper lobe mass was found and, with his strong history of tobacco abuse, a right upper lobectomy was performed with negative lymph nodes and margins but the pathology consistent with metastatic papillary eccrine adenocarcinoma. He first presented at our facility 3 years later with a chest wall mass and biopsy, again, demonstrated metastatic papillary eccrine adenocarcinoma. Pathology of the mass demonstrated multiple fragments of tissue containing metastatic adenocarcinoma. Immunohistochemistry disclosed these to be tumor cells positive for pancytokeratin, S100, SOX-10, and p63, and negative for TTF-1, CK20, Napsin, and CDX2. In review, with the initial left index finger excision, this was diagnostic of metastatic papillary eccrine adenocarcinoma.

      eccrine-2.jpg

      4c3880bb027f159e801041b1021e88e8 Result

      Section not applicable

      8eea62084ca7e541d918e823422bd82e Conclusion

      Aggressive digital papillary adenocarcinoma is a rare tumor of the eccrine sweat glands with marked metastatic potential often affecting the hands and presenting as a slowly growing mass or cystic lesion.

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