Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Edward McCarthy, M.D. and prepared by Danielle Wehle, M.D.
Case 1: A 20 year old man who was previously healthy presented a three month history of pain in his lower leg.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 290: Case 1
A 20 year old man who was previously healthy presented a three month history of pain in his lower leg. Radiographs revealed an aggressive radiolytic lesion in the mid-portion of his tibia./images/Adaman..jpg
/images/adam2.jpg
/images/Adama.jpgCorrect
Answer: Adamantinoma
Histology: none provided
Discussion: Adamantinoma is a primary bone tumor which is almost exclusively located in the mid-portion of the tibia. Histologically, there are clusters of epithelioid cells which stain positive for keratin. Adamantinoma is a malignant neoplasm with a potential to metastasize. The radiographs show aggressive bone destruction with soft tissue mass.
The lesion is not metastatic carcinoma because age 20 is extremely young for a primary epithelial malignancy. Therefore, metastatic carcinoma, which is also keratin positive, is an unlike possibility. The location of this lesion in the distal tibia is highly suggestive of adamantinoma.
The lesion is not an osteofibrous dysplasia because of the aggressive radiolytic lesion and the very cellular nests of epithelial cells. Osteofibrous dysplasia is related to adamantinoma, but it is not malignant. This lesion occurs almost exclusively in the mid-shaft of the tibia, as does adamantinoma. However, the usual radiographic feature is that of an inactive lesion. Osteofibrous dysplasia also has occasional keratin positive cells. But, large groups of epithelial cells, as in this case, are not typical of osteofibrous dysplasia.
The lesion is not a Ewing’s sarcoma. Although, there are sheets of round cells, the organoid nests of the cells indicate that they are epithelial. Occasionally, a Ewing’s sarcoma will have an adamantinoma-like pattern. However, keratin will not be a striking feature in this form of Ewing’s sarcoma.
Incorrect
Answer: Adamantinoma
Histology: none provided
Discussion: Adamantinoma is a primary bone tumor which is almost exclusively located in the mid-portion of the tibia. Histologically, there are clusters of epithelioid cells which stain positive for keratin. Adamantinoma is a malignant neoplasm with a potential to metastasize. The radiographs show aggressive bone destruction with soft tissue mass.
The lesion is not metastatic carcinoma because age 20 is extremely young for a primary epithelial malignancy. Therefore, metastatic carcinoma, which is also keratin positive, is an unlike possibility. The location of this lesion in the distal tibia is highly suggestive of adamantinoma.
The lesion is not an osteofibrous dysplasia because of the aggressive radiolytic lesion and the very cellular nests of epithelial cells. Osteofibrous dysplasia is related to adamantinoma, but it is not malignant. This lesion occurs almost exclusively in the mid-shaft of the tibia, as does adamantinoma. However, the usual radiographic feature is that of an inactive lesion. Osteofibrous dysplasia also has occasional keratin positive cells. But, large groups of epithelial cells, as in this case, are not typical of osteofibrous dysplasia.
The lesion is not a Ewing’s sarcoma. Although, there are sheets of round cells, the organoid nests of the cells indicate that they are epithelial. Occasionally, a Ewing’s sarcoma will have an adamantinoma-like pattern. However, keratin will not be a striking feature in this form of Ewing’s sarcoma.
