Treatment of osteofibrous dysplasia and associated lesions.
OBJECTIVE
To report long term treatment outcomes of osteofibrous dysplasia and association with adamantinoma.


METHODS
From January 1984 to July 2001, 14 patients with osteofibrous dysplasia were followed for an average of 108 months (78 to 260 months). Our patient group consisted of 6 men and 8 women, with a mean age of 13.9 years (2 to 65 years). We reviewed the clinical and pathological features of all 14 patients.


RESULTS
Thirteen patients had a lesion in the tibia, while one patient had lesions in both the tibia and the fibula. Initial treatments were observation after biopsy (6 patients), curettage with or without a bone graft (3 patients), resection followed by a free vascularized fibular bone graft (4 patients), or resection and regeneration with the Ilizarov external fixation (1 patient). Curettage was performed on 6 patients due to recurrence or progression after the initial treatment. Among these patients, one was diagnosed with AD from the biopsy of the recurrent lesion. This patient was further treated by segmental resection and pasteurization. After the initial pathology slides of the 13 patients were reviewed with immunohistochemical cytokeratin staining, one patient diagnosis was changed from osteofibrous dysplasia to osteofibrous dysplasia-like adamantinoma.


CONCLUSIONS
Some patients with osteofibrous dysplasia require close observation because of the high association risk between osteofibrous dysplasia and adamantinoma, Immunohistochemical staining may be helpful in differentiating these two diagnoses.
Hahn
Soo Bong
SB
Department of Orthopedic Surgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. sbhahn@yumc.yonsei.ac.kr
Kim
Sung Hun
SH
Cho
Nam Hoon
NH
Choi
Chul Jun
CJ
Kim
Bom Soo
BS
Kang
Ho Jung
HJ
D050398:Adamantinoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005360:Fibula / Q000737:chemistry / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013977:Tibia / Q000737:chemistry / Q000000981:diagnostic imaging / Q000601:surgery
D007633:Keratins