Radiologische Befunde beim Adamantinom der langen Röhrenknochen

Bohndorf, Klaus; Nidecker, Andreas; Mathias, K; Zídková, H; Kaufmann, H; Jundt, Gernot

doi:10.1055/s-2008-1033006

Cited by 16 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This part of the bone is slightly expanded, deformed, the tumor has a cystic or more often a multiloculated appearance with more or less sclerotic rim. The cortical bone is thinned, in other cases partially or extensively destroyed without any periosteal reaction [29].…”

Section: Discussionmentioning

confidence: 99%

Adamantinoma of Long Bones: A Long-term Follow-up Study of 11 Cases

Szabó

Antal

Arató

2008

Pathol. Oncol. Res.

View full text Add to dashboard Cite

The aim of this study was to evaluate the clinicopathological features and prognostic significances of 11 histologically proven adamantinoma cases based on an average 12,7 year long follow-up. The male: female ratio was 8:3, aged between 4 and 80 years (mean 29,3 years). The initial diagnosis at referral was other than adamantinoma in six patients (fibrous dysplasia, carcinoma metastasis, osteofibrous dysplasia, bone cyst, non-ossifying fibroma), referring to the differential diagnostic problems. All tumors were localized to the mid part of tibia. By histological evaluation, basaloid pattern on a background of fibrotic stroma dominated in six patients, while spindle and squamous features were less frequently seen. All adamantinoma were positive for cytokeratins often in coexpression with vimentin. No correlation was experienced between histology and clinical outcome. Intralesional curettage (2 pts) was followed by recurrence of the tumor. Wide resection was performed in eight patients with reconstruction using intercalary fibula autografts in seven patients. Reconstruction-related complications occurred in two third of the cases, all of them could however be controlled by repeated surgery. Six recurrences occurred in four patients, two of these recurrences occurred 20 and 16 years after initial surgery. One patient died 9 years after recognition of the tumor of pulmonary metastases. Adamantinoma of the long bones is a low grade malignant tumor, which clinical outcome is difficult to predict based on histology or surgical stage of the tumor. Wide surgical margin, e.g. resection the tumor reduces the rate of recurrence. This study underlines that recurrences do occur even decades after recognition the tumor, therefore a life-long follow-up of the patient is necessary.

show abstract

Section: Discussionmentioning

confidence: 99%

Adamantinoma of Long Bones: A Long-term Follow-up Study of 11 Cases

Szabó

Antal

Arató

2008

Pathol. Oncol. Res.

View full text Add to dashboard Cite

show abstract

“…Tumor has a cystic, multilocated feature with a sclerotic rim. The cortical bone is thinned and ultimately destroyed without any periosteal reaction (22).…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Adamantinoma of Long Bones: A Long-Term Follow-Up Study

et al. 2016

View full text Add to dashboard Cite

Background: Adamantinoma of long tubular bones is a rare primary malignant bone tumor. According to the literature, different prognosis and recurrence rates have been reported. Objectives: The purpose of this case series study was to evaluate the clinical behavior and prognostic features of adamantinoma of long bones. Patients and Methods: In this study, 13 histologically proven cases of adamantinoma of long bones which were treated in our hospital during March 1977 to June 2015 were evaluated. The mean follow-up period was 72 ± 44.4 months. The male:female ratio was 10:3, aged between 13 and 63 years at the time of diagnosis (mean = 24.8 ± 13.1 years). There was a period between the onset of disease and definite diagnosis (mean: 17.5 ± 14.7 months). In two cases according to the imaging and clinical symptoms the lesion seemed to be osteofibrous dysplasia, but during the follow-up, the diagnosis was changed to adamantinoma when open biopsy and pathologic assessment were performed. In 10 cases the tumor was located in the tibial diaphysis, in two cases the location was the distal shaft of the femur, and in one case the location was proximal of the humerus. All the cases underwent wide resection and intercalary or osteoarticular allograft reconstruction as the main surgery after primary incisional biopsy. Results: In eight cases, at least one local recurrence happened in an average 33.4-month period after the wide resection. In four of these patients rather than one local recurrence was occurred, but in one patient despite pulmonary metastasis the patient underwent pulmonary lobectomy and was alive at the end of the study. Allograft-related complications happened in five cases (two infections, one osteoarthritis of ankle, and two allograft fractures). For five patients ultimately recurrence and complication lead to amputation. Six patients died because of this disease, in all of which pulmonary metastasis occurred. The five-year survival rate in this study was 69%. Conclusions: Adamantinoma of long bone is a low-grade malignant tumor; however, wide resection tends to local recurrence and metastasis to the lung. Recurrence and metastasis can occur many years after surgery and there is a long disease-free period between the first wide resection and first recurrence and metastasis. This study underlined that despite the low-grade pathologic feature of this tumor, its behavior is like a high grade sarcoma and it may be better to perform sufficient wide resection at the first surgery with wide clear margin to reduce the rate of recurrence, but this approach needs to be assessed by prospective studies. According to clear wide margins for all of our cases, we guess this high interest for recurrence may be due to skip lesions of this tumor along the affected bone or even in the neighbor bones.

show abstract

“…Examining flow cytometry and p-53 expression, IHC studies demonstrated up to 48% expression of p53 proteins in all classical subtypes [33] , [34] . P-63 is also a reliable marker in adamantinomas [35] . E-, P- and N- cadherin, as well as osteonectin are expressed in classical subtype whereas in OFD adamantinoma expression of nuclear factor kB ligand, macrophage cerebrospinal fluid and osteoclastogenic factors are seen [29] , [36] .…”

Section: Introductionmentioning

confidence: 98%