Total tibia replacement using an allograft (in a patient with adamantinoma). Case report and review of literature.
BACKGROUND
Adamantinoma is a very rare, low-grade, malignant bone tumour that accounts for approximately 0.4% of all primary bone tumours. Radiographically, adamantinomas vary in length, have a clearly defined outline, with a bubbly appearance and increase the width of the bone. Histologically, epithelial cells, endothelial cells synovial cells have been implicated as cells of origin.


METHODS
We present a case of adamantinoma of the tibia, in which a resection of the whole tibia and reconstruction with a total tibia allograft was necessary.


CONCLUSIONS
The histological diagnosis is sophisticated. It is often difficult to distinguish an adamantinoma from other tumours. The most frequent described method to treat adamantinoma is wide resection and the use of an allograft. The most common complication is fracture presented similarly in our patient.


CONCLUSIONS
A total tibia allograft as presented in our case is not described in the literature. It fractured due the first year after implantation. Using a prosthesis system instead of the allograft might have saved the limb of our patient.
Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University of Würzburg, Oberdürrbacherstrasse 6, 97080 Würzburg, Germany. frey_s@chirurgie.uni-wuerzburg.de
Sönke P
SP
Frey
Jendrik
J
Hardes
Helmut
H
Ahrens
Winfried
W
Winkelmann
Georg
G
Gosheger
D050398:Adamantinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D006801:Humans; D008297:Male; D013977:Tibia / Q000601:surgery* / Q000637:transplantation; D014184:Transplantation, Homologous