Morphologic diversity of long bone adamantinoma. The concept of differentiated (regressing) adamantinoma and its relationship to osteofibrous dysplasia

Czerniak, Bogdan; Rojas–Corona, R. R.; Dorfman, Howard D.

doi:10.1002/1097-0142(19891201)64:11<2319::aid-cncr2820641123>3.0.co;2-0

Cited by 147 publications

(99 citation statements)

References 22 publications

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“…An adamantinoma subtype has been described ("differentiated adamantinoma") which occurs intracortically in the first two decades of life and is characterized histologically by a predominantly osteofibrous dysplasia-like pattern and a small inconspicuous component of epithelial elements scattered within the stromal fibroblastic tissue. 13 Classic adamantinoma typically affects patients older than 20 years and exhibits variable histological patterns to include basaloid, spindle, tubular, and squamoid. Czerniak et al 13 proposed the existence of a continuum of fibro-osseous lesions with osteofibrous dysplasia at one end of the spectrum, classic adamantinoma at the other, and differentiated adamantinoma intermediately.…”

Section: Discussionmentioning

confidence: 90%

“…13 Classic adamantinoma typically affects patients older than 20 years and exhibits variable histological patterns to include basaloid, spindle, tubular, and squamoid. Czerniak et al 13 proposed the existence of a continuum of fibro-osseous lesions with osteofibrous dysplasia at one end of the spectrum, classic adamantinoma at the other, and differentiated adamantinoma intermediately.…”

Section: Discussionmentioning

confidence: 99%

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Extra Copies of Chromosomes 7, 8, 12, 19, and 21 are Recurrent in Adamantinoma

Koike

Antonescu

Scott

et al. 2001

The Journal of Molecular Diagnostics

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Adamantinoma of long bones is a rare low-grade malignant bone tumor most often arising in the tibia, but also occasionally exhibiting synchronous involvement of the ipsilateral fibula. Some adamantinomas have "osteofibrous dysplasia-like" features. 1 Thus, a relationship between adamantinoma and osteofibrous dysplasia (a benign fibro-osseous lesion occurring almost exclusively in the tibia of children less than 10 years of age) has been proposed. This relationship, however, is poorly understood.Cytogenetic analyses of adamantinoma and osteofibrous dysplasia are few. [2][3][4][5][6][7] In this study, the cytogenetic and molecular cytogenetic findings of four cases of adamantinoma and a review of the literature are presented. Materials and Methods Case 1A 37-year-old female presented with a nontender protuberance in the midshaft of the right tibia known since childhood. As a child, she sustained a fracture of the tibia with minimal trauma. The fracture was treated in a cast and healed without complications. For 20 years, the protuberance remained unchanged in size and character and without symptoms. In 1999, however, she sustained a fracture of the tibia once again and with minimal trauma. Plain radiographs demonstrated a pathological fracture through a destructive process including the lesion and protuberance. A biopsy revealed adamantinoma. A radical en bloc resection of the right tibial diaphysis and reconstruction using fresh frozen allograft tibia, plates, and autologous bone graft were performed.Histopathologically, both the biopsy and resected specimens were composed of epithelial-like cells arranged in large islands or nests embedded in a densely fibrous stroma. Mitotic figures could not be identified. Immunohistochemical staining revealed that the epithelial cells were immunoreactive for cytokeratin (AE1:AE3). The histopathological diagnosis was classic adamantinoma. Case 2A 20-year-old male sought medical attention because of pain in the anterior aspect of his right leg with recreational running. Four years earlier, the patient had noted a bulge on the anterior border of his right tibia. Plain radiographs revealed a bubbly lesion involving the anterolateral cortex of the midshaft of the right tibia. Comparison with previous radiographs over the past 4 years showed indolent progression (Figure 1). Magnetic resonance imaging (MRI) demonstrated a multilobulated mass that uniformly enhanced with contrast. A bone scan showed intense uptake confined to the site of the lesion seen in the plain radiographs and revealed no other areas of significant skeletal uptake. An incisional biopsy was followed by a wide local excision and reconstruction.Microscopically, the lesional tissue was intracortical. At the periphery, the cortex demonstrated enlarged Harversian canals filled with a paucicellular fibroblastic reactive tissue. There was a transition from mature to less mature bone tissue, or so-called zoning. The center of the lesion

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Extra Copies of Chromosomes 7, 8, 12, 19, and 21 are Recurrent in Adamantinoma

Koike

Antonescu

Scott

et al. 2001

The Journal of Molecular Diagnostics

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“…Cytokeratin was demonstrated by immunohistochemistry using the monoclonal antibody CAM 5.2 (Moll's numbers 8, 18) and tonofilaments were seen by electron microscopy in a few tumor cells. Other primary bone tumors known to have epithelial features are adamantinoma of long bones [5], rare cases of primary multipotential bone tumor [6,7], malignant fibrous histiocytoma [8], and, recently, osteosarcoma [9, lO].…”

Section: Discussionmentioning

confidence: 99%

Ewing's sarcoma of humerus with epithelial differentiation

1995

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“…Czerniak et al (1989) in proposing a different correlation between OFD and adamantinoma, suggesting that adamantinoma can be divided into two distinct groups. The first group is the classic adamantinoma that involves the cortex and medulla of the tibia and usually occurs in young adults.…”

Section: "Osteofibrous Dysplasia-like" Adamantinomamentioning

confidence: 99%

A Classic Adamantinoma Arising from Osteofibrous Dysplasia-Like Adamantinoma in the Lower Leg: A Case Report and Review of the Literature

Hatori

Watanabe

Hosaka

et al. 2006

Tohoku J. Exp. Med.

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Adamantinoma is known as a low-grade malignant biphasic tumor. Classic adamantinoma is in general characterized by admixture of both epithelial and osteofibrous components that are associated with various proportions and differentiation patterns. Osteofibrous dysplasia (OFD) is a self-limited benign fibro-osseous lesion of bone during infancy and childhood. OFD-like adamantinoma is characterized by predominance of osteofibrous tissues, in which small groups of epithelial cells are only detected by careful search or immunohistochemistry. There have been controversies as to the potential correlation among OFD, OFD-like adamantinoma and classic adamantinoma. We report an unusual case of adamantinoma arising in the tibia, with an extensive review of the literature. The present findings suggest a direct correlation between OFD-like adamantinoma and classic adamantinoma. At the age of 12 years, the tibial biopsy lesion was diagnosed as OFD. At the age of 23, the lesion became larger and more destructive on X-ray films. The biopsy lesion was diagnosed as classic adamantinoma. Wide excision was performed. The primary lesion was retrospectively diagnosed as OFD-like adamantinoma because of presence of keratin-positive epithelial cells within the stroma. At five years after surgery, the patient was free from recurrence or metastasis. The retrospective histological findings of OFD-like adamantinoma in the original biopsy and of a classic adamantinoma in all sections of the later resection specimen raised the possibility of an unusual progression of OFD-like adamantinoma to a classic adamantinoma. The present case and the literature review suggest that an OFD-like adamantinoma may be a precursor lesion of classic adamantinoma. Therefore, the possibility of progression of OFD-like adamantinoma to a classic adamantinoma should be kept in mind, particularly when the destructive changes are seen radiologically.

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Morphologic diversity of long bone adamantinoma. The concept of differentiated (regressing) adamantinoma and its relationship to osteofibrous dysplasia

Cited by 147 publications

References 22 publications

Extra Copies of Chromosomes 7, 8, 12, 19, and 21 are Recurrent in Adamantinoma

Extra Copies of Chromosomes 7, 8, 12, 19, and 21 are Recurrent in Adamantinoma

Ewing's sarcoma of humerus with epithelial differentiation

A Classic Adamantinoma Arising from Osteofibrous Dysplasia-Like Adamantinoma in the Lower Leg: A Case Report and Review of the Literature

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