Rifi, M; Mahfoud, M; Zouaidia, F; El Yaacoubi, M
Adamantinoma is a rare primary low-grade malignant tumor composed of cells with epithelial and fibrous characteristics. It represents 0.4% of all primitive malignant bone tumours. It is predominantly located in the mid-shaft of tibia. We report an adamantinoma of the clavicle, occurring in a 19-year-old female patient. The lateral half of the clavicle was excised. After a period of 3 years, she is still remaining free of local recurrence and metastatic disease. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Gao Zhenhua; Chen Yingming; Guan Jian; Meng Junfei
Objective: To analyze the clinical, imaging and pathological features of adamantinoma of long bone to aid preoperative diagnosis. Methods: A case of adamantinoma of long bone was reported and the related literature was reviewed. Results: Literature review showed that long bone ameloblastoma was more common in young adults older than 20 years of age (86.3%) and occurred mainly in the tibial shaft (90%). The clinical, imaging and pathological features in our patient were consistent with those reported in the literature. Among 39 cases in the Chinese literature, radiographic findings included uni-or multi-cystic bone destruction with well-defined borders (87.2%), bone expansion (61.8%), partial loss of cortical bone (26.5%), bone sclerosis (38.2%), and no periosteal new bone reaction (100%). Pathology showed epithelial and fibrous differentiation. Conclusion: Adamantinoma of long bone should be considered in patients older than 20 years of age with tibial lesions that have imaging characteristics of benign bone tumors or some malignant features. (authors)
Rijn, Rick van; Maas, Mario; Bras, Johannes; Schaap, Gerard; Berg, Henk van den
Adamantinoma is a rare slow-growing malignant bone tumour. To describe the imaging appearances of six childhood cases and review the published literature. The database of the Working Group on Paediatric Oncology, Academic Medical Centre/Emma Children's Hospital Amsterdam, was searched for cases of adamantinoma. Additionally a literature study was performed to identify cases of adamantinoma in childhood. We identified six local cases of adamantinoma of the long bones, two boys (age 3 and 8 years) and four girls (mean age 8.8 years, range 3.0-14.0 years). The location of the tumour was the tibia in five and the tibia and fibula in one patient. In two patients initially a different diagnosis was made, which led to a delay in appropriate treatment. None of the children showed pulmonary metastases and all underwent total gross resection. On follow-up (mean 6.1 years, range 1.6-12.0 years) all children remained disease-free. Besides a discussion of our six patients, imaging features, histopathology, surgical approach and a literature review of childhood adamantinomas is presented. Although the incidence of adamantinoma is low, it is important to recognize this rare bone tumour, since in the early stages of the disease adequate treatment will result in an excellent prognosis. (orig.)
Osteofibrous dysplasia, osteofibrous dysplasia-like adamantinoma and adamantinoma: correlation of radiological imaging features with surgical histology and assessment of the use of radiology in contributing to needle biopsy diagnosis
Khanna, Monica; Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Clinical Radiology, Stanmore, Middlesex (United Kingdom); Delaney, David; Tirabosco, Roberto [Royal National Orthopaedic Hospital NHS Trust, Department of Histopathology, Stanmore, Middlesex (United Kingdom)
The aim of this study was to correlate the imaging features with surgical histology for tibial osteofibrous dysplasia (OFD), osteofibrous dysplasia-like adamantinoma (OFD/LA) and classical adamantinoma and to determine the additional role of imaging in suggesting a correct diagnosis in cases of needle biopsy misdiagnosis. This is a retrospective audit of 24 patients presenting over a 9-year period to a specialist orthopaedic oncology unit. Radiographic and axial magnetic resonance imaging (MRI) characteristics were recorded for each patient. The needle biopsy diagnosis and resection specimen histological diagnoses were retrospectively reviewed and compared with the imaging findings. The 24 cases comprised five OFD, 11 OFD/LA and eight adamantinoma based on surgical resection histology. The mean length of OFD was 6.1 cm (range 2-8.5 cm), for OFD/LA was 6.5 cm (range 2-13 cm) and for adamantinoma was 13.2 cm (range 6.5-26 cm). Seven of eight adamantinomas had moth-eaten margins compared to five of 11 OFD/LA and two of five OFDs. Three of eight adamantinomas demonstrated cortical destruction, with seven of eight cases completely involving the marrow cavity. In comparison, only one of 11 OFD/LA cases and one of five OFD cases demonstrated cortical destruction, and complete marrow involvement was rare. Four of 19 cases had a different needle biopsy result compared to the final histology, three cases being upgraded from an OFD/LA or OFD to classical adamantinoma. The radiological features of these three cases were more in keeping with a diagnosis of adamantinoma. A diagnosis of classical adamantinoma is suggested by an extensive lesion with moth-eaten margins and complete involvement of the medullary cavity on axial MR imaging. Misdiagnosis on needle biopsy may occur in up to one fifth of cases, and radiological features can assist in making the correct diagnosis. (orig.)
Full Text Available A clinicohistopathological study of a rare case of adamantinoma of long bone in a 78-year-old patient is presented. The cytological features when evaluated in conjunction with clinical and radiologic features are sufficiently diagnostic. The primary knowledge of its existence and knowledge of its cytological features are important for a correct preoperative cytological diagnosis.
Albert N. Van Geel
19 years after the initial treatment. Lung metastasectomy by sternotomy was carried out twice in a period of over 312 years. The patient is currently alive without evidence of other metastatic disease.
Zidkova, H.; Matejovksy, Z.; Kolar, J.; Horn, V.; Sprindrich, J.; Beran, J.; Slavik, M.
Two intriguing tumours in the appendicular skeleton are coined by odontogenic terms: the adamantinomas and cementomas (or cementifying fibromas ). Both are extremely rare, mainly the latter. Eight verified observations are presented here: five adamantinomas and three cementomas. Whereas in adamantinomas, the localization and radiographic picture was very typical in all cases, only one cementoma was found in the metaphysis of a long tubular bone in our survey. Diaphyseal tibial localization in one, and metacarpal in another patient are the first two atypical localizations described for this tumor in the world's medical literature. Angiography is characteristic for a benign expansive lesion and should be carried out in all cases. An en bloc resection is the intervention of choice for both these entities.
Ieni, Antonio; Barresi, Valeria; Grosso, Maddalena; Speciale, Giuseppe; Rosa, Michele A; Tuccari, Giovanni
By immunohistochemistry, lactoferrin (LF) has been extensively investigated in human neoplastic tissues; moreover, LF is able to promote bone growth in a murine model. Until now, no systematic studies on human osteocartilagineous fetal samples have been performed in comparison to corresponding neoplastic specimens to verify if LF may represent an oncofetal marker in this field of pathology. By a monoclonal antibody (clone 1A1; Biodesign International; w.d. 1:75) the distribution pattern of LF in bones of 25 human fetal tissues (8-34 gestation weeks), 10 adults (47-82 years) and 30 cartilage as well as 27 bone tumours (9-76 years) was analyzed. LF was encountered in 23/57 cases of osteocartilagineous tumors and namely in 10/10 giant cell tumours, 5/7 osteoid osteomas, 3/3 chondroblastomas, 3/3 chondromyxoid fibromas, 1/1 myeloma, 1/1 adamantinoma. No LF immunoexpression was detected in osteosarcomas, chondrosarcomas, ossifying fibromas, osteochondroma and enchondromas. In embryo-fetal tissues, LF immunoreactivity was localized in mesenchymal cells as well as in chondroblasts at the 8th gestational week and in immature osteocytes and osteoblasts up to the 18th gestation week, with a considerable decrease by the 24th week. No LF expression was found in any bone district since the 30th and up to the 34th week of gestation as well as in corresponding adult samples. Our findings indicate a role for LF as a bone growth regulator in the early phases of the human endochondral ossification, although the hypothesis of LF as oncofetal marker appears questionable in bone tumours.
Horácio M. Canelas
Full Text Available Os craniofaringiomas, embora raros entre os tumores intracranianos, representam o tipo mais freqüente de neoplasia congênita do sistema nervoso. Os autores referem a constituição e a ulterior destruição parcial do ducto hipofisário, de cujos restos êsses tumores derivam. Expõem as classificações dos craniofaringiomas sob os pontos de vista macroscópico (císticos, semicísticos e sólidos, histopatológico (cistos epiteliais mucosos, adamantinomas e epiteliomas planocelulares e topográfico (selares, supra-diafragmáticos e intracrânio-selares. A propósito da incidência, ressalta a maior freqüência nas duas primeiras décadas, embora os craniofaringiomas não sejam exclusivos dos jovens. Predominam ligeiramente no sexo masculino. A sintomatologia é estudada de acôrdo com a situação supradiafragmá-tica (manifestações predominantemente hipotálamo-quiasmáticas ou selar (distúrbios das funções gônado e somatotrófica da hipófise. As alterações radiológicas são de grande valor para o diagnóstico, particularmente as que se revelam no craniograma (calcificações e erosões selares, pneumencefalografia, pneumo e iodoventriculografia, e arteriografia cerebral. No tocante ao tratamento dos craniofaringiomas, os autores referem as controvérsias existentes sôbre os resultados da radioterapia. O tratamento cirúrgico comporta técnicas variadas, desde a punção transesfenoidal (hoje quase abandonada, até a craniotomia frontal ou frontotemporal. O problema da excisão radical é discutido, salientando-se as dificuldades na sua consecução, dadas as aderências do tumor com as vias ópticas na região quiasmática, as artérias regionais e o hipotálamo. A elevada mortalidade operatória é atribuida principalmente à manipulação do hipotálamo e ao colapso hipofisário. É estudado com minúcias o emprêgo do ACTH ou cor-tisona associado à cirurgia. São de prever bons resultados do tratamento com r