G. Kuruvilla et Gc. Steiner, OSTEOFIBROUS-DYSPLASIA-LIKE ADAMANTINOMA OF BONE - A REPORT OF 5 CASES WITH IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL STUDIES, Human pathology, 29(8), 1998, pp. 809-814
This report describes five cases of osteofibrous dysplasia-like adaman
tinoma of the tibia in young patients ranging from ages 4 1/2 to 14 ye
ars. Radiologically and histologically these cases were indistinguisha
ble from osteofibrous dysplasia of bone, and no epithelial cells; were
recognized on routine staining, However, epithelial differentiation w
as seen in the form of scattered keratin-positive cells in all five ca
ses, and tonofilaments in four cases. The patients were treated by cur
ettage, and three had recurrences. Follow-up showed no progression to
classic adamantinoma. Osteofibrous dysplasia-like adamantinoma is a sp
ecial histological type of adamantinoma that affects children and adol
escents. It differs from classic adamantinoma in that it lacks conspic
uous nests and masses of epithelial cells, and the prognosis after con
servative treatment is generally good. Recent publications suggest tha
t osteofibrous dysplasia-like adamantinoma is a precursor of classic a
damantinoma, In a comparative study of three cases of classic adamanti
noma, we found, in the fibroblastic stroma of the tumors, spindle epit
helial cells that were indistinguishable from the epithelial cells of
osteofibrous dysplasia-like adamantinoma. This finding suggests that t
here is an overlap between these conditions. Four additional cases of
osteofibrous dysplasia of the tibia from our files lacked epithelial d
ifferentiation. It is most likely that osteofibrous dysplasia is part
of the morphologic spectrum of adamantinoma. Copyright (C) 1998 by W.B
. Saunders Company.