Table 3

Differences between Osteofibrous dysplasia and Adamantinoma

Features
Osteofibrous dysplasia
Adamantinoma

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
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

Limited to anterior cortex
Single or multiple nodular lesions in one or more foci in medulla

Well marginated with marginal sclerosis, ground glass appearance
Sharply or poorly delineated osteolytic lesion. with septations and peripheral sclerosis, characteristic "soap-bubble" appearance
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