Pediatric Adamantinoma

  • Etiology: Primary malignant bone tumor
  • Imaging:
    — Location: Tibial diaphysis, originates in cortex
    — Lytic or blastic: Lytic
    — Matrix: (chondroid, osteoid, fibrous)
    — Zone of transition: (wide, narrow)
    — Periosteal new bone or cortical destruction: None
    — Additionally:
  • Imaging Radiograph:
    — Multilocular
    — Slightly expansile
    — Excentric
    — Osteolytic
    — Cortical lesion
    — No periosteal reaction
  • Imaging CT:
    — Lytic lesion
    — Excentric epicenter in cortex
    — May have calcifications
  • Imaging MRI: Solitary lobulated lesion or multiple nodules
    — T1WI: Decreased signal
    — T1WI post contrast: Marked enhancement
    — T2WI: Increased signal in lesion which may have fluid-fluid levels
  • DDX: Osteofibrous dysplasia
  • Complications:
  • Treatment: Surgical
  • Clinical: Teen and young adults

Radiology Cases of Adamantinoma