Disseminating adamantinoma of the tibia.

Patient. This report describes a patient with a primary long bone adamantinoma. The lesion was initially wrongly diagnosed as fibrous dysplasia and the patient was treated by curettage. At second local recurrence, the tumour had progressed from an osteofibrous dysplasia-like to a full-blown classic adamantinoma, with metastatic potential to the lungs 19 years after the initial treatment. Lung metastasectomy by sternotomy was carried out twice in a period of over 3.5 years. The patient is currently alive without evidence of other metastatic disease.Discussion. From the files of the Netherlands Committee on Bone Tumors, another five patients with lung metastaseswere studied. All types of adamantinoma should be treated by complete en bloc resection. For patients with metastatic spread to the lungs, close radiological follow-up and excision of tumour nodules seems to be the only logic treatment modality.