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Periosteal Ewing-like adamantinoma

M Fukunaga¹, S Ushigome

¹Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan.

Virchows Archiv : an International Journal of Pathology

|November 10, 1998

Summary

This study describes a rare Ewing-like adamantinoma in a 15-year-old boy's tibia. Surgical removal led to a positive outcome with no recurrence after 16 months.

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Area of Science:

Orthopedic Oncology
Skeletal Pathology
Tumor Histopathology

Background:

Adamantinoma is a rare primary bone tumor, typically occurring in the long bones.
Ewing-like adamantinoma is a rare subtype with histological features overlapping with Ewing sarcoma.
Periosteal tumors are less common than intramedullary bone tumors.

Observation:

A 15-year-old boy presented with a Ewing-like adamantinoma of the periosteal region of the right tibia.
The tumor was well demarcated, unencapsulated, and caused cortical bone erosion.
Histology revealed neoplastic cells in trabecular and cord-like patterns with varied stroma, mild atypia, and rare mitoses.

Findings:

Immunohistochemistry showed expression of keratin, epithelial membrane antigen, leu 7, synaptophysin, Ewing's sarcoma-related antigen O13, neuron-specific antigen, vimentin, and CD68.
The tumor was negative for S-100 protein, desmin, alpha-smooth muscle actin, and muscle-specific actin.
Flow cytometry indicated the tumor was aneuploid.

Implications:

This case expands the understanding of the histological and immunohistochemical spectrum of adamantinoma.
The findings highlight the importance of comprehensive diagnostic workup for differentiating bone tumors with overlapping features.
Successful surgical management suggests a favorable prognosis for this specific type of periosteal adamantinoma.

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