Tibial Adamantinoma: Analysis of Seven Consecutive Cases in a Single Institution

Abstract

Objective:Adamantinoma accounts for less than 1% of the primary bone neoplasms. The tibia is the most affected bone and it is predominant in male patients between the second and third decades of life. The objective of this study is to obtain epidemiological and clinical information on patients with adamantinoma of the tibia treated surgically between 1989 and 2016.Methods:Retrospective series of seven patients diagnosed with adamantinoma of the tibia that underwent surgery at the orthopedic oncology service of our hospital. The information was obtained from the medical records and histopathological reports of our institution.Results:A total of 2870 medical records with histological reports were evaluated. Seven cases of adamantinoma of the tibia were included. The mean age was 28.5 (17-49) years. We found a predominance of females (71.4%) and the most affected side was the left one, with four cases (57.1%). The biopsy revealed bone adamantinoma in four (57.1%) patients, while the diagnosis of the other patients was confirmed after the histological examination of the surgical specimen. All the patients underwent surgery as definitive treatment. No positive margins were reported. No local recurrence (LR) was reported and two patients had distant metastasis (DM).Conclusion:The prognosis of survival in cases of adamantinoma of the tibia is high. The rates of LR and DM were low. Surgical treatment with extensive tumor resection is the treatment of choice. Level of Evidence IV, Case Series.

17 Yaşında Erkek Hastada Sol Proksimal Tibiada Ağrısız Lezyon: Adamantinoma

“…Adamantinoma olgularının çoğunluğu uzun kemiklerin merkezinde görülür, bu lezyonların %85'i tibiada görülür. Daha nadir olarak fibula ve ulna da etkilenir (5,9). Bizim olgumuz da literatüre uygun şekilde tibia yerleşimli idi.…”

“…A B C tedir (5). Bizim hastamız da proksimal kruriste ağrısız hızlı büyüyen bir şişlik ile başvurdu.…”

“…Bir malign kemik tümörü olan adamantinomanın tedavisi hakkında ise, nadir görülmesi nedeniyle literatür verileri sınırlıdır. Adamantinoma tanılı tüm olgularda tercih edilen tedavi tümörün geniş rezeksiyonu ve defektif alanın rekonstrüksiyondur (1,5,9,16,17).…”

Epidemiological Study of Adamantinoma from US Surveillance, Epidemiology, and End Results Program: III Retrospective Analysis

“…Pain is the main symptom reported by the patients [6,7]. X-ray usually shows an aggressive pattern, and a poorly sclerotic lesion with radiolucent areas is seen [8]. Adamantinoma treatment involves extensive resection of the lesion and reconstruction of bone defect.…”

“…Considering adamantinomas are low-grade tumors, radical surgical interventions such as amputation should be avoided as much as possible [9]. Several procedures including autograft, allograft, bone transport, and endoprosthesis have been described for reconstruction [8]. Chemotherapy or radiotherapy has no place in treatment, and local recurrence and, furthermore, distant metastasis are rare, and if metastasis develops, it is most commonly in lungs [4,10].…”