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case_images: (A), Anteroposterior (AP) radiograph of the right tibia showing a lytic expansile lesion in the mid-diaphysis (indicated by a red arrow). Adjacent to this lesion, cortical irregularities are noted (Orange arrow), along with a solid type of periosteal reaction (green arrow). (B), Lateral radiograph of the same leg, further illustrating the expansile lytic lesion (gray arrow) and an adjacent lytic satellite lesion (blue arrow).
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case_images: There are also small adjacent lytic satellite lesions (Figure 1A and B).
case_images: (A) (10x magnification) and (B), (20x magnification): Hematoxylin and Eosin (H&E) stained histologic sections from the tibial bone biopsy. These sections display tissue comprising variable-sized tubules and cords of basaloid cells characterized by monomorphic round nuclei and scant cytoplasm. This cellular arrangement is interspersed within a hypocellular spindle fibrous stroma, contributing to the histopathological diagnosis.
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case_images: The histopathology results showed biphasic tumoral tissue composed of mildly atypical round to oval cells arranged in tubular structures and basaloid nests along with variably cellular fibrous stroma which confirmed a diagnosis that was least expected: adamantinoma, a rare and often aggressive type of bone tumor (Figure 2A and B). 