Adamantinoma

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Adamantinoma
Diagnosis in short

Adamantinoma. H&E stain.

LM biphasic tumour - epithelial component & fibro-osseous component
Subtypes classic, differentiated
LM DDx vascular tumours (epithelioid hemangioendothelioma), metastatic carcinoma
Site bone - classically tibia, other sites

Prevalence uncommon
Prognosis benign +/-locally aggressive
Clin. DDx osteosarcoma

Adamantinoma is an uncommon benign bone tumour.

It should not be confused with adenomatoid tumour.

General

Features:[1]

  • Rare: < 1% of bone tumours.
  • Typically 25-35 years old.
  • Benign, may be locally aggressive.

Gross

  • Classically mid portion of tibia.[2]
    • Fibula common.
    • Reported in many other sites.

Radiology

  • Intracortical, radiolucent.

Microscopic

Features:

  • Biphasic tumour:[2]
    1. Fibro-osseous component.
      • Spindle cells.
    2. Epithelial component.
      • Classically nests of basaloid cells.

Note:

  • It is described as resembling ameloblastoma,[2] but the resemblance isn't striking.

DDx:[3]

Subtypes

Subdivided into:[2]

  • Classic.
  • Differentiated - less than 20 years old only.

Images

www:

IHC

Features:[3]

  • CK14 +ve (HMWK).[5]
  • CK19 +ve (LMWK).
  • CK8/18 -ve (LMWK).

See also

References

  1. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 650. ISBN 978-0781765275.
  2. Jump up to: 2.0 2.1 2.2 2.3 2.4 Jain, D.; Jain, VK.; Vasishta, RK.; Ranjan, P.; Kumar, Y. (2008). "Adamantinoma: a clinicopathological review and update.". Diagn Pathol 3: 8. doi:10.1186/1746-1596-3-8. PMID 18279517.
  3. Jump up to: 3.0 3.1 URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970057-2. Accessed on: 28 April 2011.
  4. URL: http://southbaypath.org/CaseImages/sb5260/sb5260.htm. Accessed on: 7 December 2010.
  5. URL: http://www.nordiqc.org/Epitopes/Cytokeratins/cytokeratins.htm. Accessed on: 28 April 2011.