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Adamantinoma: metastatic disease masquerading as a gynaecological malignancy
  1. Sarah Smyth,
  2. Susan Addley,
  3. Moiad Alazzam and
  4. Hooman Soleymani majd
  1. Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Hooman Soleymani majd; hooman.soleymani{at}ouh.nhs.uk

Abstract

Adamantinoma is a rare low-grade malignancy of the appendicular skeleton with unclear histogenesis. We present the case of a 65-year-old woman with known recurrent and metastatic right tibial disease despite clear resection margins. On further investigation, a positron emission tomography–CT scan identified a primary breast lesion and an 11 cm mass in the right iliac fossa of suspected ovarian malignancy amenable to surgical resection. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and resection of a retroperitoneal mass arising from the pelvic sidewall encompassing the iliac vasculature. The patient made an uneventful recovery with histology confirming disease metastasising to the pelvis. Currently, clinical management guidelines are not available. We present an overview of adamantinoma and highlight a previously undocumented gynaecological oncology surgical approach to this novel disease location. Regarding metastases, we acknowledge the challenges of investigation pertaining to disease site and origin as well as a paucity of recommendations for surveillance and follow-up.

  • obstetrics and gynaecology
  • cancer - see oncology
  • orthopaedics

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Footnotes

  • Contributors Dr SS had direct input into patient care, performed the literature search and wrote the manuscript. Dr SA had input into patient care and proofread the manuscript. Dr MA had input into patient care and proofread the manuscript. Dr HSM had direct input into patient care, performed the surgery, performed the literature search and wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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