Diagnostic pitfalls in tibial adamantinoma: two cases with a clinicopathological review

Adamantinoma is a rare primary bone tumor that commonly arises in the jaw and has also been described in the appendicular skeleton such as the tibia. We report 2 cases of tibial adamantinomas that were originally misdiagnosed; one as fibrous dysplasia of the tibia and the other as a cutaneous eccrine carcinoma in a groin mass, which was metastatic adamantinoma to the inguinal lymph nodes. Such metastatic adamantinoma to the groin lymph nodes is extremely rare. The clinical and pathological data with a review of the available literature on inguinal lymph node metastases from primary tibial adamantinoma are reported. Increased clinical awareness and accurate recognition of such uncommon patterns of inguinal nodal metastases are imperative for appropriate planning of therapeutic strategies and risk management in these patients.