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Differences between Osteofibrous dysplasia and Adamantinoma |
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| Features |
Osteofibrous dysplasia |
Adamantinoma |
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| Nature |
Benign condition |
Locally aggressive |
| Age |
Less than 10 years |
2 year to 86 years |
| Site |
May involve both tibia and fibula. |
90% tibial involvement, In 10–15% cases, ipsilateral fibular involvement, Rarely pretibial soft tissue and other bones |
| Clinical presentation |
• Pain, swelling, pseudoarthrosis, bowing, pathological fracture may occur |
• With or without Pain, swelling, pathological fracture in 25% cases |
| • seldom progresses during childhood, and any progression of the lesion stops after puberty |
• progressive during adult age |
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| Predisposing history of trauma |
Absent |
Present |
| Radiology |
Periosteal reaction present |
Periosteal reaction is variable |
| Intra cortical |
15% of cases, there is extracortical extension into soft tissues |
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| Limited to anterior cortex |
Single or multiple nodular lesions in one or more foci in medulla |
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| Well marginated with marginal sclerosis, ground glass appearance |
Sharply or poorly delineated osteolytic lesion. with septations and peripheral sclerosis, characteristic "soap-bubble" appearance |
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| Histopathology |
Zonal phenomenon present Scattered epithelial cells recognized on IHC |
Absent Presence of epithelial cells forming small nests/strands recognized in H&E |
| Recurrence |
Local recurrence in 25%. |
Tends to recur in 18–32% |
| Metastasis |
No metastasis |
Metastases may occur in 15–30%, Lung and Lymph nodes usually involved |
| Regression |
Spontaneous regression at puberty in 33% cases |
Regression ± [45] |
Jain et al. Diagnostic Pathology 2008 3:8 doi:10.1186/1746-1596-3-8 |
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