1
|
Yaynishet YA, Fayisa ST, Dencha BA, Hailu SS. Tibial Adamantinoma: A Case Report from a Resource-Limited-Setting. Int Med Case Rep J 2024; 17:221-225. [PMID: 38559496 PMCID: PMC10979669 DOI: 10.2147/imcrj.s440401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Adamantinoma is an infrequent, low-grade malignant bone tumor, predominantly affecting the tibia and often presents diagnostic challenges due to its nonspecific radiographic characteristics. Case Presentation A 55-year-old military personnel, with no history of trauma, who presented with a one-year history of right leg swelling and pain. Radiological examination showed right anterior tibial, mid diaphyseal lytic expansile lesion with internal trabeculations and excisional biopsy led to the diagnosis of adamantinoma. Below knee amputation was done as a definitive management. Conclusion Despite diagnostic challenges adamantinoma presents, the patient was referred to oncology and underwent amputation, underscoring the importance of considering adamantinoma in differential diagnosis for persistent bone lesions.
Collapse
|
2
|
Bora N, Kashikar SV, Parihar P, Raj N, Shetty ND, Nunna B. Adamantinoma: An Uncommon Cause of Bone Pain in a Young Adolescent Male. Cureus 2023; 15:e50214. [PMID: 38192952 PMCID: PMC10772315 DOI: 10.7759/cureus.50214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/09/2023] [Indexed: 01/10/2024] Open
Abstract
Adamantinoma, an uncommon low-grade primary malignant bone tumor, rarely causes leg pain in adolescents and typically manifests in the lower extremities, with a notable preference for the tibia, although occurrences in other bones such as the femur, fibula, and pelvis have been documented. Instances of local recurrence and regional metastasis are infrequent. This case report aims to comprehensively review the clinical presentation, imaging features, histological findings, and management of adamantinoma. The presented case involves a 17-year-old male patient with a four-year history of edema and discomfort in the right anterior leg. Radiographic examination of the proximal tibia revealed a well-defined, expansile lytic-sclerotic lesion with multiple septae and a partially sclerotic border. Subsequent magnetic resonance imaging (MRI) confirmed the nature of the lesion, and a biopsy, followed by histological analysis, confirmed the diagnosis of adamantinoma. This case highlights the significance of a multidisciplinary approach, emphasizing close collaboration among radiology, pathology, and orthopedic oncology in adamantinoma management. Long-term follow-up is imperative for monitoring recurrence and administering timely therapy. The objective of this case report is to contribute to an improved understanding of adamantinoma and offer guidance on the treatment of this uncommon bone tumor.
Collapse
Affiliation(s)
- Nikita Bora
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivali V Kashikar
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratap Parihar
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nishant Raj
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha D Shetty
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhagyasri Nunna
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
3
|
Pes M, Pulino A, Cardinale U, Pisanu F, Manunta AF. Atypical Presentation of Non-Ossifying Fibroma in a Professional Muay Thai Boxer: A Case Report and a Narrative Review of the Literature. J Orthop Case Rep 2023; 13:149-154. [PMID: 37521385 PMCID: PMC10379257 DOI: 10.13107/jocr.2023.v13.i07.3790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/17/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Sports injuries occur during sport athletic activities, or exercising. However, there are some lesions which are typically associated to sports, in such a demanding and physical sport like Muay Thai that no typical lesion has been detected yet. We performed a narrative review of the literature to highlight the typical lesions of this sport to analyze the differential diagnosis of those conditions. Case Report A 28-year-old female, Muay Thai athlete since 16 years, presented with a 6 months history of a persistent pain in the metaphyseal lateral part of the right tibia. Differentiation between stress injuries, malignant bone tumors, and tumor-like lesions after repetitive microtrauma following sport activities can be difficult. The diagnostic approach involved conventional X-ray, echotomography, computed tomography scan, and magnetic resonance imaging scan with controversial findings. The biopsy confirmed the final diagnosis of non-ossifying fibroma. Conclusion The purpose of this case report is to exhibit the challenges in the diagnosis of a professional Muay Thai athlete with tibial pain and to discuss the clinical presentation of this type of patients with a limited population in the literature. Our case illustrates that even modern imaging techniques cannot always distinguish between tumor and tumor-like lesions caused by sports; meanwhile remembered us that we should never be too focused on a particular characteristic forgetting even rare pathologies as adamantinoma.
Collapse
Affiliation(s)
- Marco Pes
- Department of Orthopaedic, University of Sassari, Sassari, Italy
| | - Alessio Pulino
- Department of Orthopaedic, University of Sassari, Sassari, Italy
| | | | - Francesco Pisanu
- Department of Orthopaedic, University of Sassari, Sassari, Italy
| | | |
Collapse
|
4
|
Sahu SA, Mishra JK, Kar BK, Manju R, De M. Adamantinoma of tibia: excision and reconstruction with free vascularized fibula flap: a case report and review of literature. J Surg Case Rep 2022; 2022:rjac165. [PMID: 35441002 PMCID: PMC9013241 DOI: 10.1093/jscr/rjac165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/27/2022] [Indexed: 11/21/2022] Open
Abstract
Adamantinoma is a rare malignant tumour usually affecting the diaphysis of long bones. The tumour most commonly affects the tibia. Conventional management involves excision with a wide margin, reconstruction and sometimes amputation. Multiple options are available, but reconstruction depends upon the size of the bony defect and available resources. None has proved to be the favourable one. We have analysed the advantages and shortcomings of various methods used. In our case, a 33-year-old male patient presented with a large adamantinoma of the midtibial region of the left leg, which was managed with excision and reconstruction of long segment bony defect with free vascularized osteocutaneous fibula flap. There are osseointegration and hypertrophy of the vascularized bone with good functional gain in long term follow-up. Autologous bone reconstruction after adamantinoma excision with microvascular free fibula flap in large bone segment defects salvage the limb with satisfactory functional outcome.
Collapse
Affiliation(s)
- Shamendra Anand Sahu
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Jiten Kumar Mishra
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Bikram Keshari Kar
- Department of Orthopedic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - R Manju
- Department of General Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Moumita De
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| |
Collapse
|
5
|
D'Souza AM, Bahrami A, Akeson J, Fahey T, Mitchell C, King R. A case of progressive, metastatic adamantinoma in a pediatric patient. Pediatr Blood Cancer 2021; 68:e29239. [PMID: 34264541 DOI: 10.1002/pbc.29239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/05/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Amber M D'Souza
- Department of Pediatrics, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Armita Bahrami
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jeffrey Akeson
- Department of Pediatric Orthopedic Surgery, OSF St. Francis Medical Center, Peoria, Illinois, USA
| | - Tim Fahey
- Department of Pediatric Radiology, OSF St. Francis Medical Center, Peoria, Illinois, USA
| | - Craig Mitchell
- Department of Pediatric Radiology, OSF St. Francis Medical Center, Peoria, Illinois, USA
| | - Robert King
- Department of Interventional Radiology, OSF St. Francis Medical Center, Peoria, Illinois, USA
| |
Collapse
|
6
|
Zapata Laguado M, Canales Pacheco EL, Sanchez Castillo JO. Adamantinoma Presenting With Local Recurrence and Inguinal Lymph Node Metastasis: A Case Report. Cureus 2021; 13:e13439. [PMID: 33763322 PMCID: PMC7981846 DOI: 10.7759/cureus.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Adamantinoma of long bones is a slow-growing, low-grade primary malignant bone tumor. It is a rare entity and accounts for less than 1% of all primary bone tumors, and in most cases, it occurs in the mid-axis of the tibia of adolescents and young adults. In this report, we describe the case of a 53-year-old woman with a diagnosis of adamantinoma of the left tibia who was initially treated surgically in 2004. Two years later, she presented with local relapse, for which she underwent new surgical management. The patient was referred to our practice 16 years after the initial diagnosis, and she presented with recurrence characterized by ipsilateral inguinal lymph node metastasis. The histological findings and immunohistochemistry were compatible with metastatic adamantinoma with high-grade differentiation, which ultimately required surgical salvage management.
Collapse
Affiliation(s)
- Martin Zapata Laguado
- Clinical Oncology, Universidad el Bosque/Instituto Nacional de Cancerología, Bogota, COL
| | | | | |
Collapse
|
7
|
Schutgens EM, Picci P, Baumhoer D, Pollock R, Bovée JVMG, Hogendoorn PCW, Dijkstra PDS, Rueten-Budde AJ, Jutte PC, Traub F, Leithner A, Tunn PU, Funovics P, Sys G, San-Julian M, Schaap GR, Dürr HR, Hardes J, Healey J, Capanna R, Biau D, Gomez-Brouchet A, Wunder J, Cosker TDA, Laitinen MK, Niu X, Kostiuk V, van de Sande MAJ. Surgical Outcome and Oncological Survival of Osteofibrous Dysplasia-Like and Classic Adamantinomas: An International Multicenter Study of 318 Cases. J Bone Joint Surg Am 2020; 102:1703-1713. [PMID: 33027124 PMCID: PMC8569856 DOI: 10.2106/jbjs.19.01056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Osteofibrous dysplasia-like adamantinoma (OFD-AD) and classic adamantinoma (AD) are rare, neoplastic diseases with only limited data supporting current treatment protocols. We believe that our retrospective multicenter cohort study is the largest analysis of patients with adamantinoma to date. The primary purpose of this study was to describe the disease characteristics and evaluate the oncological outcomes. The secondary purpose was to identify risk factors for local recurrence after surgical treatment and propose treatment guidelines. METHODS Three hundred and eighteen confirmed cases of OFD-AD and AD for which primary treatment was carried out between 1985 and 2015 were submitted by 22 tertiary bone tumor centers. Proposed clinical risk factors for local recurrence such as size, type, and margins were analyzed using univariable and multivariate Cox regression analysis. RESULTS Of the 318 cases, 128 were OFD-AD and 190 were AD. The mean age at diagnosis was 17 years (median, 14.5 years) for OFD-AD and 32 years (median, 28 years) for AD; 53% of the patients were female. The mean tumor size in the OFD-AD and AD groups combined was 7.8 cm, measured histologically. Sixteen percent of the patients sustained a pathological fracture prior to treatment. Local recurrence was recorded in 22% of the OFD-AD cases and 24% of the AD cases. None of the recurrences in the OFD-AD group progressed to AD. Metastatic disease was found in 18% of the AD cases and fatal disease, in 11% of the AD cases. No metastatic or fatal disease was reported in the OFD-AD group. Multivariate Cox regression analysis demonstrated that uncontaminated resection margins (hazard ratio [HR] = 0.164, 95% confidence interval [CI] = 0.092 to 0.290, p < 0.001), pathological fracture (HR = 1.968, 95% CI = 1.076 to 3.600, p = 0.028), and sex (female versus male: HR = 0.535, 95% CI = 0.300 to 0.952, p = 0.033) impacted the risk of local recurrence. CONCLUSIONS OFD-AD and AD are parts of a disease spectrum but should be regarded as different entities. Our results support reclassification of OFD-AD into the intermediate locally aggressive category, based on the local recurrence rate of 22% and absence of metastases. In our study, metastatic disease was restricted to the AD group (an 18% rate). We advocate wide resection with uncontaminated margins including bone and involved periosteum for both OFD-AD and AD. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- E M Schutgens
- Departments of Orthopedic Surgery (E.M.S., P.D.S.D., and M.A.J.v.d.S.), Histopathology (J.V.M.G.B.), and Pathology (P.C.W.H.), Leiden University Medical Center, Leiden, the Netherlands
- London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - P Picci
- Medical Oncology, Musculoskeletal Oncology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - D Baumhoer
- Bone Tumour Reference Centre, Institute of Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - R Pollock
- London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - J V M G Bovée
- Departments of Orthopedic Surgery (E.M.S., P.D.S.D., and M.A.J.v.d.S.), Histopathology (J.V.M.G.B.), and Pathology (P.C.W.H.), Leiden University Medical Center, Leiden, the Netherlands
| | - P C W Hogendoorn
- Departments of Orthopedic Surgery (E.M.S., P.D.S.D., and M.A.J.v.d.S.), Histopathology (J.V.M.G.B.), and Pathology (P.C.W.H.), Leiden University Medical Center, Leiden, the Netherlands
| | - P D S Dijkstra
- Departments of Orthopedic Surgery (E.M.S., P.D.S.D., and M.A.J.v.d.S.), Histopathology (J.V.M.G.B.), and Pathology (P.C.W.H.), Leiden University Medical Center, Leiden, the Netherlands
| | - A J Rueten-Budde
- Mathematical Institute, Leiden University, Leiden, the Netherlands
| | - P C Jutte
- Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - F Traub
- Orthopedic Surgery, University of Tübingen, Tübingen, Germany
| | - A Leithner
- Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - P-U Tunn
- Orthopedic Surgery, Helios-Clinics, Berlin, Germany
| | - P Funovics
- Orthopedic Surgery, Medical University of Vienna, Vienna, Austria
| | - G Sys
- Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium
| | - M San-Julian
- Orthopedic Surgery, University of Navarra, Pamplona, Spain
| | - G R Schaap
- Orthopedic Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | - H R Dürr
- Department of Tumor Orthopedics and Sarcoma Surgery, University Hospital Essen, Essen, Germany
| | - J Hardes
- Musculoskeletal Oncology, Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Munich, Germany
| | - J Healey
- Orthopedic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Capanna
- Department of Orthopaedics, S. Chiara University Hospital, University of Pisa, Italy
| | - D Biau
- Orthopedic Surgery, Cochin Hospital, Paris, France
| | - A Gomez-Brouchet
- Department of Histopathology, University Medical Center, Toulouse, France
| | - J Wunder
- University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - T D A Cosker
- Orthopedic Surgery, Nuffield Orthopedic Center, Oxford, United Kingdom
| | - M K Laitinen
- Orthopedic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - X Niu
- Department of Orthopedic Oncology, Beijing Jishuitan Hospital, Beijing, People's Republic of China
| | - V Kostiuk
- Orthopedic Surgery, National Cancer Institute Ukraine, Kiev, Ukraine
| | - M A J van de Sande
- Departments of Orthopedic Surgery (E.M.S., P.D.S.D., and M.A.J.v.d.S.), Histopathology (J.V.M.G.B.), and Pathology (P.C.W.H.), Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
8
|
Epidemiological Study of Adamantinoma from US Surveillance, Epidemiology, and End Results Program: III Retrospective Analysis. JOURNAL OF ONCOLOGY 2020; 2020:2809647. [PMID: 32612653 PMCID: PMC7315319 DOI: 10.1155/2020/2809647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/04/2020] [Accepted: 05/21/2020] [Indexed: 12/28/2022]
Abstract
Objective Adamantinomas are rare low-grade malignant bone tumors. This study aims to describe the demographic characteristics and survival rates of patients suffering from adamantinomas. Methods The National Institute of Cancer Surveillance, Epidemiology, and Recent Results (SEER) database was used, and patients diagnosed with adamantinoma between 1973 and 2016 were screened. Patients were classified according to sex, age, race/ethnicity, and marital status, and also tumors were classified according to year of diagnosis, laterality, type of treatment, and follow-up. Results The mean age of patients was 30.8 ± 16.7 (range: 4–75). A total of 92 patients were identified; of these, 43 were females and 49 were males. The mean follow-up period was 138.1 ± 90.3 (range: 1–156) months. Mean survival duration was 287.8 ± 15.4 (95% CI: 257.7–317.9) months. Five- and ten-year survival rates were 98.8% and 91.5%, respectively. Besides, survival time was also observed to be independent of gender, age groups, race, marital status, tumor location, and year of diagnosis. Conclusion Adamantinoma is a very rare bone tumor that affects the long bones in lower extremities and is more common in men. Five- and 10-year survival prognoses are reasonably satisfactory. Also, survival time is independent of variables such as gender, age, and tumor location.
Collapse
|