Mohs Micrographic Surgery as a Digit-Sparing Treatment for Aggressive Digital Papillary Adenocarcinoma

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Aggressive digital papillary adenocarcinoma (ADPAca) is a rare and histologically challenging malignant eccrine neoplasm with a high propensity for local recurrence and metastasis. Classically, the lesion presents as a nonpainful, firm, tan-gray to white–pink, rubbery nodule on the volar surface of the upper digits.1–3 Treatment of ADPAca has thus far been primarily limited to wide excision with or without digital amputation and subsequent close, long-term follow-up for recurrence and metastatic disease.2,3 While effective in providing local control, amputation may leave the patient with disfigurement and disability. A case of ADPAca treated with Mohs micrographic surgery (MMS) as a digit-sparing alternative to amputation with no evidence of recurrence or metastasis 2 years postoperatively was presented here.
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