Abstract Aggressive digital papillary adenocarcinoma (ADPA) is a rare tumor of the sweat glands. It has a high rate of recurrence, as well as metastasis, and shows an affinity for metastasis to the lungs and lymph nodes. Despite this being a known characteristic of the tumor, the role of the sentinel lymph node biopsy in ADPA remains unclear. We present a case of ADPA in which a sentinel lymph node biopsy was performed. In addition, we have reviewed the literature for all reported instances of sentinel lymph node biopsies in cases of ADPA. We have found that the rate of subclinical metastasis to the lymph nodes in cases where a SLNB was performed to be 17%. This is higher than the previously reported metastatic rate of 9-11%. In addition, all patients with a negative SLNB were alive and well at most recent follow-up. Given our experience and review of the literature, we strongly recommend consideration of a SLNB in cases of ADPA to provide a clearer understanding of the prognosis. 
 
Keywords: Digital adenocarcinoma; Hand tumors; Rare tumors; Sentinel lymph node biopsy