Purpose: Digital papillary adenocarcinoma (DPA) is a rare sweat gland tumour first described in the literature in 1987(1), and quoted at a rate of 0.08 per million people per year(2). It is most common in the distal digits, with fingers being more frequently involved than toes(3), and shows a male predominance – up to four times higher in males than females(2). DPA was previously known as Aggressive DPA, due to its characteristic aggressive behaviour and its propensity for recurrence and potential distant metastases. We describe two cases of DPA seen in Western Australia. Methodology: Retrospective review of two patients’ cases following their presentation. Results: Two cases of men in their thirties with DPA presented within months of each other. In both cases, the presumed diagnosis was of a benign entity, most likely a mucoid cyst. Pathology determined a far rarer diagnosis, with immunohistochemistry playing a critical role. They were both worked up with pre-operative staging scans, however one underwent a sentinel lymph node biopsy at the time of his procedure, highlighting the limited consensus on how to treat this rare pathology. Conclusion: DPA should remain in the differential for all seemingly benign cysts and tumours of the digits. All excised lesions should be sent for histology regardless of the surgeon’s certainty of a cystic diagnosis. Ongoing research into the molecular characteristics of this rare tumour will likely aid diagnoses in the future. Given the aggressive nature and metastatic potential for this tumour, it is likely that SLNBx may become standardised practice in the future, in line with other aggressive tumours such as Merkel cell carcinoma. However more research is required to determine the prognostic benefit of SLNBx and establish whether it could be important in overall disease-free survival, with longer follow-up data being crucial given the sparsity in the current literature.