title: Adamantinoma of the spine: case report.
abstract: OBJECTIVE
  We report a patient with a cervicothoracic spinal and a mandibular adamantinoma. Adamantinoma is a rare malignant neoplasm of bone and, to our knowledge, there have been only five cases of spinal adamantinoma reported. The pathogenesis of the adamantinoma, as well as the management of this extremely rare spinal tumor, is reviewed.
  
  
  METHODS
  A 55-year-old man was admitted to our service with cervical pain and signs of C8 and T1 radiculopathy. On physical examination, cervical spine deformity, swelling in the left mandible region, and signs of C8 and T1 radiculopathy were observed. Neuroradiology examinations showed an osteolytic mass of the C6, C7, and T1 vertebral bodies, extending into the lateral masses and transverse processes. After surgical procedures, the patient had clinical improvement.
  
  
  METHODS
  Corpectomy of C6, C7, and T1 was performed through a cervicothoracic anterior approach. Anterior stabilization of the spine was obtained using an autologous iliac crest graft and osteosynthesis with an anterior plate. On a second procedure, posterior tumor resection and spinal stabilization were performed. After the 1-year follow-up examination, a new anterior procedure was performed because of tumor recidivity and spine instability.
  
  
  CONCLUSIONS
  Adamantinoma, an extremely rare lesion, is a locally aggressive tumor with slow growth and the potential to metastasize. Although it is an extremely rare occurrence in the spine, adamantinoma should be considered on the diagnosis of tumors of the vertebrae. Neuroradiological examinations are not specific in the differentiation of this tumor from other conditions. This fact, coupled with the limited experience that most physicians in general have in dealing with this tumor, makes the diagnosis and treatment of adamantinoma challenging.
authors.affiliation: Department of Neurosurgery, Hospital Centenário, São Leopoldo, Brazil. leandrodini@ig.com.br
authors.forename: Leandro I
authors.initials: LI
authors.lastname: Dini
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Mendonça
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Adamy
authors.forename: Glauco A
authors.initials: GA
authors.lastname: Saraiva
mesh_terms: D050398:Adamantinoma / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008339:Mandibular Neoplasms / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019736:Prostheses and Implants; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012086:Reoperation; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome