Tibial Adamantinoma with Local Recurrence and Pulmonary Metastasis

Flowers, Richard; Baliga, Mithra; Guo, Ming; Liu, Shawn S.

doi:10.1159/000326018

Cited by 14 publications

(18 citation statements)

References 35 publications

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“…3,5,6 En ocasiones, el adamantinoma puede estar compuesto por células ahusadas, fusiformes, sin anaplasia, que rememoran un fibrosarcoma. 13 Tal es el caso de nuestro paciente, cuyo diagnóstico histológico inicial fue fibrosarcoma tipo adulto. En estos casos, la inmunohistoquímica confirmaría la naturaleza epitelial de este tumor; sin embargo, las secciones histológicas evaluadas no presentaron positividad para citokeratina.…”

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Adamantinoma en pediatría. Presentación de caso

et al. 2015

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Presentación de casos clínicos RESUMENEl adamantinoma es un tumor primario de los huesos largos, que afecta principalmente la diáfisis de la tibia, y es extremadamente raro en pediatría. Se presenta a partir de la segunda década de vida, con un ligero predominio en el sexo masculino. Se trata de un tumor de bajo grado, con alta agresividad a nivel local y bajo índice de metástasis y recurrencia una vez resecado en forma completa. Su diagnóstico resulta difícil, no solo por tratarse de una patología poco frecuente en pediatría, sino también por la dificultad para el diagnóstico diferencial con otras lesiones benignas. Presentamos el caso de un paciente de 15 años, con una tumoración indolora de larga evolución en la tibia distal, cuyo diagnóstico fue confirmado histológicamente con la pieza de amputación, ya que los estudios complementarios y las dos biopsias iniciales no fueron concluyentes. Aunque la mayoría de la bibliografía publicada consta de reportes de casos, y muy pocos en pacientes pediátricos, es de común acuerdo la dificultad para arribar al diagnóstico de adamantinoma. Palabras clave: adamantinoma, tumor óseo, tumor de bajo grado, pediatría.ABSTRACT Adamantinoma is a primary tumor of long bones, which affects mainly the shaft of the tibia, and is extremely rare in pediatrics. It frequently presents during the second decade of life, with a slight predominance in males. It is a low grade tumor, with local aggressiveness and low rate of metastasis and recurrence once it is completely removed. Its diagnosis is difficult, not only because it is a rare disease in children, but also because of the difficulty in the differential diagnosis with other benign lesions. We report the case of a 15-year-old patient with a painless swelling of the distal tibia, whose diagnosis was confirmed with the piece of amputation, as imaging features and both initial biopsies were not enough to achieve diagnosis. Though most of the literature consists of case reports, and very few in pediatric patients, they all agree on the difficulty in achieving the diagnosis of adamantinoma.

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“…El principal factor pronóstico para recaídas es el compromiso de los márgenes quirúrgicos. Las metástasis a pulmón y ganglios linfáticos son infrecuentes y tardías, incluso a 10 años del diagnóstico incial, 5,[12][13][14][15] por lo que es necesario un seguimiento a largo plazo.…”

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Adamantinoma en pediatría. Presentación de caso

et al. 2015

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“…Além de radiografias simples, realizamos tomografia computadorizada (TC) para evidenciar a exata localização do tumor, se cortical ou central; a ressonân-cia magnética (RM) foi útil para avaliar a extensão do tumor, a fim de orientar o cirurgião quanto aos limites da ressecção cirúrgica. Metástases podem ocorrer em 10 a 20% dos casos, sendo os pulmões o sítio mais acometido (17)(18)(19) . Raramente são detectadas metástases para linfonodos ou para outros ossos (1)(2)5,11) .…”

Section: Discussionunclassified

“…Raramente são detectadas metástases para linfonodos ou para outros ossos (1)(2)5,11) . A ressecção marginal está associada a maior risco de recidiva e metástase (17)(18)20) .…”

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Adamantinoma de ossos longos

Próspero¹,

Baptista²,

Consentino³

et al. 2008

Rev. bras. ortop.

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Primary tibial adamantinoma diagnosed by fine needle aspiration

Bishop

Ali

2009

Diagnostic Cytopathology

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Adamantinoma is one of the rarest primary bone tumors and is almost exclusively found in the tibia. Because of its scarcity, there are only a handful of reported cases of adamantinoma diagnosed by fine needle aspiration (FNA). We report a case of a 30-year-old woman seen at The Johns Hopkins Hospital for a 2.5-cm lytic lesion in the distal diaphysis of the tibia. A computed tomography-guided FNA of the lesion revealed a moderately cellular lesion consisting of a biphasic admixture of epithelioid cells seen singly and in fragments. These cells had round to oval nuclei with pale chromatin and well-formed nuclear grooves. The other population had more elongated nuclei and spindled appearance. An immunostain for cytokeratin was positive, supporting the diagnosis of adamantinoma. Due primarily to its rarity, the diagnosis of adamantinoma on FNA can be challenging and must be made in the context of its characteristic clinical and radiographic setting.

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Tibial Adamantinoma with Local Recurrence and Pulmonary Metastasis

Cited by 14 publications

References 35 publications

Adamantinoma en pediatría. Presentación de caso

Adamantinoma en pediatría. Presentación de caso

Adamantinoma de ossos longos

Primary tibial adamantinoma diagnosed by fine needle aspiration

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