49 Adamantinoma

CASE 49


Adamantinoma


George Nomikos, Anthony G. Ryan, Peter L. Munk, and Mark Murphey


Clinical Presentation


A 16-year-old boy presented with pain in the lower leg.



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Figure 49A



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Figure 49B



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Figure 49C



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Figure 49D


Radiologic Findings


The lateral radiograph of the tibia (Fig. 49A) shows a bubbly, mildly expansile, lytic lesion of the midtibia with surrounding sclerosis. The dominant lesion appears to involve the cortex and medullary canal. A smaller satellite lesion is identified proximally that appears to involve the cortical bone alone. The axial CT image (Fig. 49B) through the lesion demonstrates the cortical and medullary involvement of the dominant lesion, as well as the internal trabeculation. The sagittal T1-weighted image (Fig. 49C) shows the multifocal nature of this lesion, with the superior focus of involvement isolated to the cortex. The lesion is predominantly high signal on the T2-weighted image (Fig. 49D), with low signal intensity septations internally. Note the rim of high signal periosteal reaction surrounding the tibial cortex.


Diagnosis


Adamantinoma.


Differential Diagnosis



  • Osteofibrous dysplasia (OFD)
  • Fibrous dysplasia (FD)
  • Hemangioma
  • Angiosarcoma or other vascular malignancy

Discussion


Background

Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 49 Adamantinoma
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