Adamantinoma: Difference between revisions

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{{SI}}
{{SI}}


{{CMG}}; {{AE}}{{MA}} [mailto:malihash@bidmc.harvard.edu]
{{CMG}}; {{AE}}{{MA}} [mailto:malihash@bidmc.harvard.edu] [mailto:malihash@bidmc.harvard.edu]


{{SK}}  
{{SK}}  
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The incidence of [disease name] increases with age; the median age at diagnosis is  25 to 35  years.
The incidence of [disease name] increases with age; the median age at diagnosis is  25 to 35  years.
OR
[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
OR


[Chronic disease name] is usually first diagnosed among [age group].
[Chronic disease name] is usually first diagnosed among [age group].
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[Disease name] affects men and women equally.
OR


Men are more commonly affected by adamantinoma than women. The men to women ratio is approximately 5 to 4.<ref name="pmid3514033">{{cite journal |vauthors=Moon NF, Mori H |title=Adamantinoma of the appendicular skeleton--updated |journal=Clin. Orthop. Relat. Res. |volume= |issue=204 |pages=215–37 |date=March 1986 |pmid=3514033 |doi= |url=}}</ref>
Men are more commonly affected by adamantinoma than women. The men to women ratio is approximately 5 to 4.<ref name="pmid3514033">{{cite journal |vauthors=Moon NF, Mori H |title=Adamantinoma of the appendicular skeleton--updated |journal=Clin. Orthop. Relat. Res. |volume= |issue=204 |pages=215–37 |date=March 1986 |pmid=3514033 |doi= |url=}}</ref>
damantinoma mostly occurs in the second to fifth decade. The median patient age is 25 to 35 years, with a range from 2 years to 86 years. It is slightly more common in men than women, with a ratio of 5:4


The majority of [disease name] cases are reported in [geographical region].
The majority of [disease name] cases are reported in [geographical region].
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==Risk Factors==
==Risk Factors==
There are no established risk factors for [disease name].
OR
The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR


Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
Risk factors in the development of adamantinoma may include Benign osteofibrous dysplasia. It maybe a precursor of adamantinoma.<ref name="pmid166365232">{{cite journal |vauthors=Hatori M, Watanabe M, Hosaka M, Sasano H, Narita M, Kokubun S |title=A classic adamantinoma arising from osteofibrous dysplasia-like adamantinoma in the lower leg: a case report and review of the literature |journal=Tohoku J. Exp. Med. |volume=209 |issue=1 |pages=53–9 |date=May 2006 |pmid=16636523 |doi= |url=}}</ref>


==Screening==
==Screening==
There is insufficient evidence to recommend routine screening for [disease/malignancy].
There is insufficient evidence to recommend routine screening for adamantinoma.  


OR
==Natural History, Complications, and Prognosis==


According to the [guideline name], screening for [disease name] is not recommended.
If left untreated, 15-30% of patients with adamantinoma may metastasize to other parts of the body such as lungs or nearby lemph nodes. <ref name="pmid35140332">{{cite journal |vauthors=Moon NF, Mori H |title=Adamantinoma of the appendicular skeleton--updated |journal=Clin. Orthop. Relat. Res. |volume= |issue=204 |pages=215–37 |date=March 1986 |pmid=3514033 |doi= |url=}}</ref>. Adamantinoma has mortality rate of 13%to 18%. <ref name="pmid27432665">{{cite journal |vauthors=Keeney GL, Unni KK, Beabout JW, Pritchard DJ |title=Adamantinoma of long bones. A clinicopathologic study of 85 cases |journal=Cancer |volume=64 |issue=3 |pages=730–7 |date=August 1989 |pmid=2743266 |doi= |url=}}</ref>


OR
OR


According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
Complications of adamantinoma include metastases
 
==Natural History, Complications, and Prognosis==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].


OR
OR


Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
Prognosis is generally good. Male patint, short duration of symtoms, young age ( less than 20 years) and lack of squamous differentiantion of tumor are related with unfavorable clinical outcome. <ref name="pmid182795175">{{cite journal |vauthors=Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y |title=Adamantinoma: a clinicopathological review and update |journal=Diagn Pathol |volume=3 |issue= |pages=8 |date=February 2008 |pmid=18279517 |pmc=2276480 |doi=10.1186/1746-1596-3-8 |url=}}</ref>
 
OR


Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
===Prognosis===
Prognosis is excellent, with overall survival of 85% at 10 years, but is lower when wide surgical margins cannot be obtained.


==Diagnosis==
==Diagnosis==
===Diagnostic Study of Choice===
===Diagnostic Study of Choice===


To assure the histological diagnosis, pathologists should employ immunohistochemistry for demonstrating the sometimes sparse epithelial cell nests when the radiological features are suggestive of adamantinoma.
The diagnosis of adamantinoma is based on the findings of radiologic studies such as xray, CT and MRI.  
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
There are no established criteria for the diagnosis of [disease name].


===History and Symptoms===
===History and Symptoms===


The initial symptoms of adamantinoma are often nonspecific. The most common symptoms of  adamantinoma include swelling with or without pain. Less common symptoms of adamantinoma include pathological fracture( 23% of patients) <ref name="pmid10954102">{{cite journal |vauthors=Qureshi AA, Shott S, Mallin BA, Gitelis S |title=Current trends in the management of adamantinoma of long bones. An international study |journal=J Bone Joint Surg Am |volume=82-A |issue=8 |pages=1122–31 |date=August 2000 |pmid=10954102 |doi= |url=}}</ref> and neurological symptoms in spinal lesions.<ref name="pmid16883154">{{cite journal |vauthors=Dini LI, Mendonça R, Adamy CA, Saraiva GA |title=Adamantinoma of the spine: case report |journal=Neurosurgery |volume=59 |issue=2 |pages=E426; discussion E426 |date=August 2006 |pmid=16883154 |doi=10.1227/01.NEU.0000223497.06588.4A |url=}}</ref>   
The initial symptoms of adamantinoma are often nonspecific. The most common symptoms of  adamantinoma include swelling with or without pain. Less common symptoms of adamantinoma include pathological fracture( 23% of patients) <ref name="pmid10954102">{{cite journal |vauthors=Qureshi AA, Shott S, Mallin BA, Gitelis S |title=Current trends in the management of adamantinoma of long bones. An international study |journal=J Bone Joint Surg Am |volume=82-A |issue=8 |pages=1122–31 |date=August 2000 |pmid=10954102 |doi= |url=}}</ref> and neurological symptoms in spinal lesions.<ref name="pmid16883154">{{cite journal |vauthors=Dini LI, Mendonça R, Adamy CA, Saraiva GA |title=Adamantinoma of the spine: case report |journal=Neurosurgery |volume=59 |issue=2 |pages=E426; discussion E426 |date=August 2006 |pmid=16883154 |doi=10.1227/01.NEU.0000223497.06588.4A |url=}}</ref>   
T
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].


===Physical Examination===
===Physical Examination===
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===Laboratory Findings===
===Laboratory Findings===
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
Paraneoplastic hypercalcemia can be seen in tibial adamantinoma and pulmonary metastasis<ref name="pmid7161313">{{cite journal |vauthors=Altmannsberger M, Poppe H, Schauer A |title=An unusual case of adamantinoma of long bones |journal=J. Cancer Res. Clin. Oncol. |volume=104 |issue=3 |pages=315–20 |date=1982 |pmid=7161313 |doi= |url=}}</ref>
 
OR
 
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
 
OR
 
[Test] is usually normal among patients with [disease name].
 
OR
 
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
 
OR
 
There are no diagnostic laboratory findings associated with [disease name].


===Electrocardiogram===
===Electrocardiogram===
There are no ECG findings associated with [disease name].
There are no ECG findings associated with adamantinoma.  
 
OR
 
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


===X-ray===
===X-ray===
There are no x-ray findings associated with [disease name].
An x-ray may be helpful in the diagnosis of adamantinoma. Findings on an x-ray suggestive of adamantinoma include central or eccentric, multilocular lesion in tibia. The tumor is found in the diaphyseal location. Metaphyseal extention or only involvement of metaphysis is seen occationally. The lesions are well circumscribed surrounded ring-shaped densities ( soap -bubble appearance). The lesion are more intra-cortical, but if they destroy cortex, extracortical soft tisuue invasion can be seen. The periosteal reaction can be minimal to prominnet.<ref name="pmid169063923">{{cite journal |vauthors=Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M |title=Adamantinoma in childhood: report of six cases and review of the literature |journal=Pediatr Radiol |volume=36 |issue=10 |pages=1068–74 |date=October 2006 |pmid=16906392 |doi=10.1007/s00247-006-0272-5 |url=}}</ref>
 
OR
 
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===Echocardiography or Ultrasound===
===Echocardiography or Ultrasound===
There are no echocardiography/ultrasound  findings associated with [disease name].
There are no echocardiography/ultrasound  findings associated with adamantinoma.  
 
OR
 
Echocardiography/ultrasound  may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no echocardiography/ultrasound  findings associated with [disease name]. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===CT scan===
===CT scan===


Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
CT scan may be helpful in the diagnosis of adamantinoma. Findings on CT scan suggestive of adamantinoma include cortical involvement and the soft tissue extension if it exist.
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].


OR
Chest CT scan can detect pulmonary metastasis. <ref name="pmid169063922">{{cite journal |vauthors=Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M |title=Adamantinoma in childhood: report of six cases and review of the literature |journal=Pediatr Radiol |volume=36 |issue=10 |pages=1068–74 |date=October 2006 |pmid=16906392 |doi=10.1007/s00247-006-0272-5 |url=}}</ref>
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
 
There are no CT scan findings associated with [disease name].
 
OR
 
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===MRI===
===MRI===
There are no MRI findings associated with [disease name].
MRI is helpful in the diagnosis of adamantinoma. It is useful in detection distant cortical foci, soft tissue, and intramedullary extension. MRI is a very important diagnostic study for stating of tumor and tumor-free margins. Findings on MRI suggestive of adamantinoma include a solitary lobulated focus or multiple small nodules in one or more foci. Tumors demonstrate low signal intensity on T1-weighted images and high signal on T2-weighted images.<ref name="pmid15547221">{{cite journal |vauthors=Van der Woude HJ, Hazelbag HM, Bloem JL, Taminiau AH, Hogendoorn PC |title=MRI of adamantinoma of long bones in correlation with histopathology |journal=AJR Am J Roentgenol |volume=183 |issue=6 |pages=1737–44 |date=December 2004 |pmid=15547221 |doi=10.2214/ajr.183.6.01831737 |url=}}</ref>
 
OR
 
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===Other Imaging Findings===
===Other Imaging Findings===
There are no other imaging findings associated with [disease name].
Bone scan may be helpful in the diagnosis of adamantinoma. Findings on a nuclear medicine suggestive of adamantioma include:<ref name="pmid182795174">{{cite journal |vauthors=Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y |title=Adamantinoma: a clinicopathological review and update |journal=Diagn Pathol |volume=3 |issue= |pages=8 |date=February 2008 |pmid=18279517 |pmc=2276480 |doi=10.1186/1746-1596-3-8 |url=}}</ref>
 
* Increased blood flow in the region of the tumor
OR
* Increased accumulation of technetium-99m methylene diphosphate in the area of the tumor
 
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


===Other Diagnostic Studies===
===Other Diagnostic Studies===
There are no other diagnostic studies associated with [disease name].
There are no other diagnostic studies associated with adamantinoma.
 
OR
 
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].


==Treatment==
==Treatment==
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Revision as of 20:25, 10 October 2018


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List of terms related to Adamantinoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3] [4]

Synonyms and keywords:

Overview

Historical Perspective

Adamantinoma was first discovered by Fischer in 1913.[1]

The first reported example is attributed to Maier in 1900 [2]. In 1913,[3] [4] named the lesion "primary adamantinoma of the tibia" because of its striking histologic resemblance to the jaw "adamantinoma" (ameloblastoma). In 1951, Schulenberg [5] suggested a unifying histogenetic concept for the adamantinomas of the appendicular skeleton.

The association between [important risk factor/cause] and [disease name] was made in/during [year/event].

In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].

In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].

There have been several outbreaks of [disease name], including -----.

In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].

Classification

There is no established system for the classification of [disease name].

Adamantinoma is classified into 2 distinct types: classic and differentiated (Osteofibrous dysplasia (OFD) - like)

Features
Classic Differentiated
Age >20 years <20 years, Children
Radiology Soft tissue or intramedullary involvement Intra cortical
Histopathology Both epithelial and osteofibrous component, solid nests of basaloid cells OFD (Osteofibrous dysplasia) like pattern, Scattered positivity of epithelial elements for cytokeratin
Behavior Aggressive Relatively benign

Pathophysiology

Adamantinoma is a low grade, malignant bone tumor. This tumor is predominnatly located in Tibia ( most in mid-portion of tibia). [4] It is a biphasic tumor including epithelial and osteofibrous components.[5].

Most locations of the tumor include:[6]

  • Tibia ( 80 to 85 percent of cases)
  • Ipsilateral fibula (10 to15% of cases)
  • Humerus
  • Ulna
  • Femur
  • Fibula
  • Radius
  • Ribs
  • Spine
  • Small bones of the hand and foot
Gross pathology: [7]
  • Yellow gray or grayish white tumor
  • Fleshy or firm in consistency
  • Some OFD like adamantinomas are solid
  • Macroscopic cysts containing blood like fluid, occasionally
Microscopic examanination: [8]
  • Admixture of both epithelial and osteofibrous component, most commonly solid nests of basaloid cells in classic adamantinoma
  • Nuclear atypia in a few cases
  • Several patterns of growth including
    • Tubular
    • Basaloid
    • Squamous
    • Spindle-cell
    • Osteofibrous dysplasia-like variant
  • A few cases from a large series have exhibited nuclear atypia
  • Foci of calcification, giant cells [9]
  • Foci of xanthoma and spindle cells[10]
Immunohistochemistry:
  • Positives for keratins 14 and 19[11]

Causes

Adamantinoma may be caused by: [12]

  • Displacement of basal epithelium of skin during embrogenesis
  • Traumatic implantation
  • Synovial origin

Differentiating Adamantinoma from Other Diseases

Adamantinoma must be differentiated from aneurrysmal bone cyst, unicamaral bone cyst, fibrous dysplasia, chondromyxoid fibroma, eosinophilic granuloma, giant cell tumor, chondromyxoid fibroma, osteomyelitis, chondrosarcoma, epithelial metastasis, hemangioendothelioma, nonossifying fibromas, angiosarcoma.

Epidemiology and Demographics

Adamantinoma is a rare bone cnacer ( 0.1–0.5% of all primary bone tumors ).

The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.

OR

In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.

OR

In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.


Patients of all age groups may develop [disease name].

OR

The incidence of [disease name] increases with age; the median age at diagnosis is 25 to 35 years.

[Chronic disease name] is usually first diagnosed among [age group].

OR

[Acute disease name] commonly affects [age group].


There is no racial predilection to [disease name].

OR

[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].


Men are more commonly affected by adamantinoma than women. The men to women ratio is approximately 5 to 4.[13]

The majority of [disease name] cases are reported in [geographical region].

OR

[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

Risk Factors

Risk factors in the development of adamantinoma may include Benign osteofibrous dysplasia. It maybe a precursor of adamantinoma.[14]

Screening

There is insufficient evidence to recommend routine screening for adamantinoma.

Natural History, Complications, and Prognosis

If left untreated, 15-30% of patients with adamantinoma may metastasize to other parts of the body such as lungs or nearby lemph nodes. [15]. Adamantinoma has mortality rate of 13%to 18%. [16]

OR

Complications of adamantinoma include metastases

OR

Prognosis is generally good. Male patint, short duration of symtoms, young age ( less than 20 years) and lack of squamous differentiantion of tumor are related with unfavorable clinical outcome. [17]

Prognosis

Prognosis is excellent, with overall survival of 85% at 10 years, but is lower when wide surgical margins cannot be obtained.

Diagnosis

Diagnostic Study of Choice

The diagnosis of adamantinoma is based on the findings of radiologic studies such as xray, CT and MRI.

History and Symptoms

The initial symptoms of adamantinoma are often nonspecific. The most common symptoms of adamantinoma include swelling with or without pain. Less common symptoms of adamantinoma include pathological fracture( 23% of patients) [18] and neurological symptoms in spinal lesions.[19]

Physical Examination

Adamantinoma may present with bowing deformity of the tibia.[20]

Spinal lesions may be manifested by neurologic symptoms in addition to pain [35].

Laboratory Findings

Paraneoplastic hypercalcemia can be seen in tibial adamantinoma and pulmonary metastasis[21]

Electrocardiogram

There are no ECG findings associated with adamantinoma.

X-ray

An x-ray may be helpful in the diagnosis of adamantinoma. Findings on an x-ray suggestive of adamantinoma include central or eccentric, multilocular lesion in tibia. The tumor is found in the diaphyseal location. Metaphyseal extention or only involvement of metaphysis is seen occationally. The lesions are well circumscribed surrounded ring-shaped densities ( soap -bubble appearance). The lesion are more intra-cortical, but if they destroy cortex, extracortical soft tisuue invasion can be seen. The periosteal reaction can be minimal to prominnet.[22]

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with adamantinoma.

CT scan

CT scan may be helpful in the diagnosis of adamantinoma. Findings on CT scan suggestive of adamantinoma include cortical involvement and the soft tissue extension if it exist.

Chest CT scan can detect pulmonary metastasis. [23]

MRI

MRI is helpful in the diagnosis of adamantinoma. It is useful in detection distant cortical foci, soft tissue, and intramedullary extension. MRI is a very important diagnostic study for stating of tumor and tumor-free margins. Findings on MRI suggestive of adamantinoma include a solitary lobulated focus or multiple small nodules in one or more foci. Tumors demonstrate low signal intensity on T1-weighted images and high signal on T2-weighted images.[24]

Other Imaging Findings

Bone scan may be helpful in the diagnosis of adamantinoma. Findings on a nuclear medicine suggestive of adamantioma include:[25]

  • Increased blood flow in the region of the tumor
  • Increased accumulation of technetium-99m methylene diphosphate in the area of the tumor

Other Diagnostic Studies

There are no other diagnostic studies associated with adamantinoma.

Treatment

Medical Therapy

There is no treatment for adamantinoma. Radition therapy and chemotherapy are not effective. [26]

Surgery

Surgery is the mainstay of treatment for adamantinoma.

  • Tumor resection with wide operative margins and then limb reconstruction [27]
  • Amputation[28]

Primary Prevention

There are no established measures for the primary prevention of adamantinoma.

Secondary Prevention

There are no established measures for the secondary prevention of adamantinoma.

References

  1. ↑ Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (February 2008). "Adamantinoma: a clinicopathological review and update". Diagn Pathol. 3: 8. doi:10.1186/1746-1596-3-8. PMC 2276480. PMID 18279517.
  2. ↑ Van Rijn, Rick; Bras, Johannes; Schaap, Gerard; van den Berg, Henk; Maas, Mario (2006). "Adamantinoma in childhood: report of six cases and review of the literature". Pediatric Radiology. 36 (10): 1068–1074. doi:10.1007/s00247-006-0272-5. ISSN 0301-0449.
  3. ↑ Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (February 2008). "Adamantinoma: a clinicopathological review and update". Diagn Pathol. 3: 8. doi:10.1186/1746-1596-3-8. PMC 2276480. PMID 18279517.
  4. ↑ Keeney GL, Unni KK, Beabout JW, Pritchard DJ (August 1989). "Adamantinoma of long bones. A clinicopathologic study of 85 cases". Cancer. 64 (3): 730–7. PMID 2743266.
  5. ↑ Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M (October 2006). "Adamantinoma in childhood: report of six cases and review of the literature". Pediatr Radiol. 36 (10): 1068–74. doi:10.1007/s00247-006-0272-5. PMID 16906392.
  6. ↑ Keeney GL, Unni KK, Beabout JW, Pritchard DJ (August 1989). "Adamantinoma of long bones. A clinicopathologic study of 85 cases". Cancer. 64 (3): 730–7. PMID 2743266.
  7. ↑ Unni KK, Dahlin DC, Beabout JW, Ivins JC (November 1974). "Adamantinomas of long bones". Cancer. 34 (5): 1796–805. PMID 4426036.
  8. ↑ Keeney GL, Unni KK, Beabout JW, Pritchard DJ (August 1989). "Adamantinoma of long bones. A clinicopathologic study of 85 cases". Cancer. 64 (3): 730–7. PMID 2743266.
  9. ↑ Donner R, Dikland R (February 1966). "Adamantinoma of the tibia. A long-standing case with unusual histological features". J Bone Joint Surg Br. 48 (1): 138–44. PMID 5909059.
  10. ↑ Weiss SW, Dorfman HD (March 1977). "Adamantinoma of long bone. An analysis of nine new cases with emphasis on metastasizing lesions and fibrous dysplasia-like changes". Hum. Pathol. 8 (2): 141–53. PMID 852865.
  11. ↑ Maki M, Saitoh K, Kaneko Y, Fukayama M, Morohoshi T (October 2000). "Expression of cytokeratin 1, 5, 14, 19 and transforming growth factors-beta1, beta2, beta3 in osteofibrous dysplasia and adamantinoma: A possible association of transforming growth factor-beta with basal cell phenotype promotion". Pathol. Int. 50 (10): 801–7. PMID 11107052.
  12. ↑ Ryrie BJ (December 1932). "ADAMANTINOMA OF THE TIBIA: AETIOLOGY AND PATHOGENESIS". Br Med J. 2 (3752): 1000–1020.1. PMC 2522231. PMID 20777206.
  13. ↑ Moon NF, Mori H (March 1986). "Adamantinoma of the appendicular skeleton--updated". Clin. Orthop. Relat. Res. (204): 215–37. PMID 3514033.
  14. ↑ Hatori M, Watanabe M, Hosaka M, Sasano H, Narita M, Kokubun S (May 2006). "A classic adamantinoma arising from osteofibrous dysplasia-like adamantinoma in the lower leg: a case report and review of the literature". Tohoku J. Exp. Med. 209 (1): 53–9. PMID 16636523.
  15. ↑ Moon NF, Mori H (March 1986). "Adamantinoma of the appendicular skeleton--updated". Clin. Orthop. Relat. Res. (204): 215–37. PMID 3514033.
  16. ↑ Keeney GL, Unni KK, Beabout JW, Pritchard DJ (August 1989). "Adamantinoma of long bones. A clinicopathologic study of 85 cases". Cancer. 64 (3): 730–7. PMID 2743266.
  17. ↑ Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (February 2008). "Adamantinoma: a clinicopathological review and update". Diagn Pathol. 3: 8. doi:10.1186/1746-1596-3-8. PMC 2276480. PMID 18279517.
  18. ↑ Qureshi AA, Shott S, Mallin BA, Gitelis S (August 2000). "Current trends in the management of adamantinoma of long bones. An international study". J Bone Joint Surg Am. 82-A (8): 1122–31. PMID 10954102.
  19. ↑ Dini LI, Mendonça R, Adamy CA, Saraiva GA (August 2006). "Adamantinoma of the spine: case report". Neurosurgery. 59 (2): E426, discussion E426. doi:10.1227/01.NEU.0000223497.06588.4A. PMID 16883154.
  20. ↑ Qureshi AA, Shott S, Mallin BA, Gitelis S (August 2000). "Current trends in the management of adamantinoma of long bones. An international study". J Bone Joint Surg Am. 82-A (8): 1122–31. PMID 10954102.
  21. ↑ Altmannsberger M, Poppe H, Schauer A (1982). "An unusual case of adamantinoma of long bones". J. Cancer Res. Clin. Oncol. 104 (3): 315–20. PMID 7161313.
  22. ↑ Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M (October 2006). "Adamantinoma in childhood: report of six cases and review of the literature". Pediatr Radiol. 36 (10): 1068–74. doi:10.1007/s00247-006-0272-5. PMID 16906392.
  23. ↑ Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M (October 2006). "Adamantinoma in childhood: report of six cases and review of the literature". Pediatr Radiol. 36 (10): 1068–74. doi:10.1007/s00247-006-0272-5. PMID 16906392.
  24. ↑ Van der Woude HJ, Hazelbag HM, Bloem JL, Taminiau AH, Hogendoorn PC (December 2004). "MRI of adamantinoma of long bones in correlation with histopathology". AJR Am J Roentgenol. 183 (6): 1737–44. doi:10.2214/ajr.183.6.01831737. PMID 15547221.
  25. ↑ Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (February 2008). "Adamantinoma: a clinicopathological review and update". Diagn Pathol. 3: 8. doi:10.1186/1746-1596-3-8. PMC 2276480. PMID 18279517.
  26. ↑ Maki M, Saitoh K, Kaneko Y, Fukayama M, Morohoshi T (October 2000). "Expression of cytokeratin 1, 5, 14, 19 and transforming growth factors-beta1, beta2, beta3 in osteofibrous dysplasia and adamantinoma: A possible association of transforming growth factor-beta with basal cell phenotype promotion". Pathol. Int. 50 (10): 801–7. PMID 11107052.
  27. ↑ Keeney GL, Unni KK, Beabout JW, Pritchard DJ (August 1989). "Adamantinoma of long bones. A clinicopathologic study of 85 cases". Cancer. 64 (3): 730–7. PMID 2743266.
  28. ↑ Khan MH, Darji R, Rao U, McGough R (July 2006). "Leg pain and swelling in a 22-year-old man". Clin. Orthop. Relat. Res. 448: 259–66. doi:10.1097/01.blo.0000195924.36103.11. PMID 16826129.


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Adamantinoma
Micrograph of an adamantinoma showing the biphasic histomorphology. H&E stain..

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List of terms related to Adamantinoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [5]

Overview

Adamantinoma is a rare bone cancer, making up less than 1% of all bone cancers. It predominantly arises in bone in a subcutaneous location (85% are in the tibia). Most commonly, patients are in their second or third decade, but it can occur over a wide age range.

Historical Perspective

  • The condition was first described by Fischer in 1913.[1]
  • Some authors still confusingly misuse the term adamantinoma to describe ameloblastomas, however they differ in histology and frequency of malignancy. The typically benign odontogenic tumor known as ameloblastoma was first recognized in 1827 by Cusack but did not yet have any designation.[2] In 1885, this kind of odontogenic neoplasm was designated as an adamantinoma by [3]and was finally renamed to the modern name ameloblastoma in 1930 by Ivey and Churchill.[4][5]

Epidemiology and Demographics

Adamantinoma is a rare bone cancer, making up less than 1% of all bone cancers. Most commonly, patients are in their second or third decade, but adamantinoma can occur over a wide age range.

Risk Factors

Benign osteofibrous dysplasia may be a precursor of adamantinoma[6][7] or a regressive phase of adamantinoma.[8]

Pathophysiology

Gross Pathology

The tumor is typically well-demarcated, osteolytic and eccentric, with cystic zones.

Microscopic Pathology

Islands of epithelial cells are found in a fibrous stroma.

Natural History, Complications, and Prognosis

Complications

Metastases are rare at presentation but may occur in up to 30% of patients during the disease course.

Prognosis

Prognosis is excellent, with overall survival of 85% at 10 years, but is lower when wide surgical margins cannot be obtained.

History and Symptoms

Patients typically present with swelling in long bones with or without pain.

Physical Examination

Extremities

The slow-growing tumor predominantly arises in long bones in a subcortical location (95% in the tibia or fibula).[9]

Diagnosis

X Ray

The tumor is typically well-demarcated, osteolytic and eccentric, with cystic zones resembling soap bubbles.[10]

Treatment

Treatment consists of wide resection or amputation.This tumor is insensitive to radiation so chemotherapy is not typically used unless the cancer has metastized to the lungs or other organs.[10]

See also

References

  1. ↑ Fischer B. Uber ein primares Adamantinom der Tibia. 12. Frankfurt: Zeitschr. f. Path.; 1913:422-441.
  2. ↑ J.W. Cusack (1827). "Report of the amputations of the lower jaw". Dublin Hosp Rec. 4: 1–38.
  3. ↑ L. Malassez (1885). "Sur Le role des debris epitheliaux papdentaires". Arch Physiol Norm Pathol. 5: 309–340 6:379–449.
  4. ↑ R.H. Ivey, H.R. Churchill, (1930). "The need of a standardized surgical and pathological classification of tumors and anomalies of dental origin,". Am Assoc Dent Sch Trans. 7: 240–245.
  5. ↑ Madhup, R; Kirti, S; Bhatt, M; Srivastava, M; Sudhir, S; Srivastava, A (Jan 2006). "Giant ameloblastoma of jaw successfully treated by radiotherapy". Oral Oncology Extra. 42 (1): 22–25. doi:10.1016/j.ooe.2005.08.004.
  6. ↑ Hatori M, Watanabe M, Hosaka M, Sasano H, Narita M, Kokubun S (May 2006). "A classic adamantinoma arising from osteofibrous dysplasia-like adamantinoma in the lower leg: a case report and review of the literature". Tohoku J. Exp. Med. 209 (1): 53–9. doi:10.1620/tjem.209.53. PMID 16636523.
  7. ↑ Springfield DS, Rosenberg AE, Mankin HJ, Mindell ER. (1994). "Relationship between osteofibrous dysplasia and adamantinoma". Clin Orthop Relat Res. (309): 234–44. PMID 7994967.
  8. ↑ Gleason, Briana C., Liegl-Atzwanger, Bernadette. "Osteofibrous Dysplasia and Adamantinoma in Children and Adolescents: A Clinicopathologic Reappraisal". American Journal of Surgical Pathology. 32 (3): 363–376. doi:10.1097/PAS.0b013e318150d53e.
  9. ↑ Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (2008). "Adamantinoma: A clinicopathological review and update". Diagn Pathol. 3: 8. doi:10.1186/1746-1596-3-8. PMC 2276480. PMID 18279517.
  10. ↑ 10.0 10.1 Ernest U. Conrad (2008). Orthopaedic Oncology: Diagnosis and Treatment. Thieme. pp. 143–145.

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