Adamantinoma BrighamRad

Description: Radiographically, adamantinomas are sharply circumscribed lesions with lucent filling defects (central or eccentric in location). The tumors are separated from normal bone cortex by a sclerotic zone. Periosteal reaction is generally absent unless the lesion is accompanied by pathologic fracture. Gross pathology shows a well-demarcated lesion with peripheral lobulated contours. Cystic cavities contain either straw-colored fluid or blood, and the lesion may contain spicules of bone. The tumors are usually eccentrically located in the bone, sparing the medullary cavity. Microscopically, adamantinomas consist of epithelial-like cells in tubular or spindle configuration. The cells stain (immunohistochemical) strongly for keratin. The tumors are locally aggressive and metastesize to lung and local lymph nodes in 20% of cases. Treatment consists of wide-block excision of the involved segment of bone. The tumor readily recurs if not completely removed.