Chest
Volume 100, Issue 1, July 1991, Pages 279-281
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Selected Reports
Adamantinoma of the Tibia with Pulmonary Metastases and Hypercalcemia

https://doi.org/10.1378/chest.100.1.279Get rights and content

Adamantinomas of long bones are rare primary malignant bone tumors. A case of a woman who died of pulmonary metastases of an adamantinoma of the tibia is presented. A unique feature of this case is the association with hypercalcemia. The association of hypercalcemia, hypophosphatemia, decreased parathyroid hormone levels and increased urinary cAMP excretion suggests a Immorally mediated hypercalcemia. Histologic and ultrastructural analysis of the pulmonary metastases demonstrated that the tumor was composed of a heterogeneous cell population with mesenchymal and epithelial differentiation.

Section snippets

Case Report

The patient was admitted to the hospital in 1959 when she was 13 years old with a pathologic tratture of the left tibia. Histologic material was not available for review. The diagnosis of adamantinoma was made in 1964, following curettage of a local recurrence.

In April 1987, she developed hemoptysis. A chest radiograph showed nodular densities in both lungs and a right-sided pleural effusion (Fig 1). Bronchoscopy revealed endobronchial lesions with histologic confirmation of adamantinoma in the

Discussion

This case history illustrates the typical clinical course of an adamantinoma of the tibia. Metastatic spread occurred to the lungs and the skeleton, the localizations most frequently cited in the literature.4 The patient ultimately died 24 years after the diagnosis of adamantinoma was made, illustrating the protracted evolution and the late occurrence of metastases.5 Curettage and local excision are inadequate treatment and often lead to local recurrence and metastatic disease. Although large

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  • Radiologic-pathologic findings of primary osseous adamantinoma with unusual metastasis to the posterior cul-de-sac in pregnancy

    2011, Clinical Imaging
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    Additionally, our patient had metastatic disease to the lungs, liver and retroperitoneum, which collectively have not been previously reported in a single patient to our knowledge. Metastatic foci have previously been reported to the ribs, lung, pleura, femur, humerus and spine [1–3]. Hazelbag et al. reported metastases to the lung and lymph nodes in 29% of 32 patients diagnosed with adamantinoma of the long bones with a clinical follow-up of 122 months [4].

  • Adamantinoma of the Tibia Mimicking a Benign Cystic Lesion: A Case Report

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    The tumor usually metastasizes to the lungs, the regional lymph nodes, or the bones.8,58 Rare pleuropulmonary manifestations, such as hemoptysis, pneumothorax,6,59 severe paraneoplastic, humorally mediated hypercalcemia, hypercalcemic coma, and pancreatitis have also been reported.58 In this article the imaging findings, diagnosis, and treatment of a patient with a distal tibial adamantinoma presenting as a cystic lesion is presented.

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