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Table 3 Differences between Osteofibrous dysplasia and Adamantinoma

From: Adamantinoma: A clinicopathological review and update

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
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]