KidsMD Health Topics

Adamantinoma

  • Bones naturally grow and change as your child gets older. However, throughout this long process, problems can sometimes occur. An adamantinoma is a slow-growing cancerous bone tumor that’s most often found in the shinbone (tibia) or the jawbone (mandible). Occasionally, these tumors grow in the forearm, hands or feet.

    A diagnosis of a bone tumorcan be overwhelming and your list of questions may seem endless. An important first step in understanding what lies ahead is familiarizing yourself with the basics about the type of tumor called and adamantinoma.

    • An adamantinoma is a rare tumor that occurs most often in boys and young men ages 10 to 30.
    • An adamantinoma is a serious condition requiring aggressive treatment.
    • The cause of this bone tumor is unknown.
    • An adamantinoma doesn’t respond to some traditional cancer treatments, such as chemotherapy or radiation. Surgery is usually recommended to remove the tumor.
    • This kind of cancer spreads to other parts of the body about 20 percent of the time.
    • The best treatment is surgical removal of the tumor.
    • Amputation is rare, but it can be necessary in some cases.
    • Ongoing follow-up care is very important for keeping your child healthy and checking to see if the tumor has grown back.
    • For most children with adamantinoma, the long-term outlook is very positive. 

    The detailed information on the following pages will help you gain a better understanding of adamantinoma and a clearer picture of what to expect.

    How Dana-Farber/Boston Children’s Cancer and Blood Disorders Center approaches adamantinoma

    The diagnosis of a life-threatening condition, like cancer, affects your entire family. We’re here to help you every step of the way. At Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, we offer the ideal setting, utilizing world-recognized cancer expertise at Dana-Farber and internationally renowned pediatric expertise at Children’s Hospital Boston within the research and educational setting of Harvard Medical School. We are a top cancer center and top children’s hospital. 

    Experts in our Bone and Soft Tissue Tumor Program are devoted to caring for children and teenagers with adamantinoma of the tibia and other bone and soft tissue disorders. Adamantinomas of the jawbone are treated through our Oral and Maxillofacial Surgery Program. Children who need surgery as part of their treatment also receive treatment through our Orthopedic Care Center

    Our multidisciplinary approach to care ensures in-depth discussion of each case and personalized treatment plans for every child. We integrate expertise from the a wide variety of specialists: 

    • pediatric oncologists, surgical oncologists and radiation oncologists
    • pediatric experts from every medical subspecialty, such as orthopedics, pathology, physical therapy and radiology
    • highly skilled and experienced pediatric oncology nurses
    • Child Life specialists, psychologists, social workers and resource specialists who provide supportive care before, during and after treatment

    Adamantinoma: Reviewed by Megan Anderson, MD, orthopedic surgeon
    © Boston Children’s Hospital, 2011

    Contact Us

    Experts in our Bone and Soft Tissue Tumor Program are devoted to caring for children and teenagers with adamantinoma of the tibia and other bone and soft tissue disorders. 

    Boston Children's Hospital
    300 Longwood Ave
    Fegan 2
    Boston MA 02115 

    617-355-6021
    fax: 617-730-0456 

     

  • We understand that you may have a lot of questions when your child is diagnosed with an adamantinoma: 

    • What exactly is it?
    • What are potential complications?
    • What are the latest treatments?
    • What are possible side effects from treatment?
    • How will it affect my child long term? 

    We’ve provided some answers to those questions here, and when you meet with our experts, we can explain your child’s condition and treatment options fully. 

    What is an adamantinoma?
    An adamantinoma is a slow growing cancerous bone tumor most often found in the shin bone (tibia) or the jaw bone (mandible). Occasionally, these tumors are found in the forearm, hands or feet. In about 20 percent of cases, adamantinoma cancer cells spread (metastasize) to other parts of the body, usually to the lungs or nearby lymph nodes. 

    Is an adamantinoma common?
    An adamantinoma is a rare tumor, occurring primarily in boys and young men (ages 10 to 30). It usually occurs after the bones stop growing. 

    Is it curable?
    An adamantinoma doesn’t respond to some traditional cancer treatments, such as chemotherapy or radiation. However, surgery to remove the tumor completely can, in some cases, cure the condition.

    Causes

    What causes an adamantinoma?
    Adamantinomas do not have an identifiable cause. If your child has an adamantinoma, he probably has sustained a trauma to the affected bone, but it’s unclear whether trauma is a cause of the tumor, or the tumor makes the bone weak and more likely to be injured.

    Signs and symptoms

    What are the symptoms of an adamantinoma?
    While symptoms of an adamantinoma may from child-to-child, the most common include: 

    • pain (sharp or dull) at the site of the tumor
    • swelling and/or redness at the site of the tumor
    • increased pain with activity or lifting
    • limping
    • decreased movement of the affected limb 

    You may have noticed these symptoms over a short period of time or they may have been occurring for six months or more. In most cases of an adamantinoma, an injury brings your child into a medical facility, where an x-ray may show abnormalities in the bone. 

    It’s important to keep in mind that the symptoms of an adamantinoma may resemble other medical problems, some of them which are very common and easy to treat, others which could be more serious. 

    Your child may experience symptoms differently from those listed above. It is important to be evaluated by a physician to get an accurate diagnosis. Always consult your child's doctor if you have concerns.

    Questions to ask your doctor

    You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your doctor’s recommendations.
     
    If your child is has been diagnosed with an adamantinoma, you probably have a lot on your mind. So it’s often helpful to write questions down. Some of the questions you may want to ask include: 

    • What does a diagnosis of an adamantinoma mean for my child?
    • How will you manage my child’s symptoms?
    • What kind of surgery will my child have?
    • How long will recovery take?
    • What are the possible short and long-term complications of treatment?
    • Will my child be OK?
    • How likely is it that the adamantinoma will come back?
    • What services are available to help my child and my family cope? 


  • The first step in treating your child is forming an accurate and complete diagnosis.

    How are adamantinomas diagnosed?
    Doctors may use specific tests and procedures to determine the exact type of tumor your child has and whether the tumor has spread. These may include: 

    • a physical exam, including checking the limb where the tumor is located
    • x-rays, which produce images of internal tissues, bones and organs onto film
    • magnetic resonance imaging (MR or MRI) to produce detailed images of the area where the tumor is located
    • a computerized tomography scan (also called a CT or CAT scan) to capture a detailed view of the body, in some cases
    • a biopsy or tissue sample from the tumor to provide definitive information about the type of tumor; this is collected during an image-guided needle biopsy
    • blood and urine tests
    • a bone scan to detect bone involvement

    After we complete all necessary tests, our experts will meet to review and discuss what they have learned about your child's condition. Then we will meet with you and your family to discuss the results and outline the best treatment options for your child.


  • We know how stressful a diagnosis of adamantinoma can be, both for your child and for your whole family. That's why our physicians are focused on family-centered care: From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs. We'll work with you to create a care plan that's best for your child.  

    Treatment can vary greatly, depending on your child's situation, including the location and size of the tumor and whether the disease has recurred. Your child's doctor and other members of your care team will discuss the options with you in-depth.

    Traditional treatments for an adamantinoma

    Because adamantinomas do not generally respond to chemotherapy and radiation, the best treatment for your child probably involves surgery. The type of surgery your child receives will depend on the size and location of the tumor, and whether the cancer has spread. Depending on these factors, your child may either need: 

    • limb-salvage surgery to help preserve the limb by removing the tumor and some healthy tissue around the tumor
    • amputation if the tumor cannot be removed by limb-salvage surgery (for example, if the cancer involves major nerves and blood vessels) 

    What is the recommended long-term care for children treated for an adamantinoma?
    Children treated for an adamantinoma require regular follow-up to screen for recurrence and complications of treatment. A typical follow-up visit may include some or all of the following: 

    • a physical exam
    • laboratory testing
    • imaging scans

    At these visits, your care team will check on your child's overall health and look for signs that the cancer may have returned.

    What happens if my child's adamantinoma has returned?
    An adamantinoma that has returned is generally treated through additional surgery.

    Coping and support

    In addition to providing exceptional medical care, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center strives to also meet all of your family's emotional and quality-of-life needs.

    We know that unfamiliar places, especially hospitals, often create anxiety and fear for a child. We also know this isn't an easy time or task for parents, who have their own fears and concerns about the situation. Our family support services will help address many of your needs and concerns.

    Read about our resources and support services.

  • A tDana-Farber/Boston Children’s Cancer and Blood Disorders Center, our care is informed by our research. 

    We are world leaders in opening new avenues of "translational research," bringing laboratory advances to the bedside and doctor's office as quickly as possible. All of our senior medical staff members of the Bone and Soft Tissue Tumors Program participate in clinical research activities.

    Our program director, Carlos Rodriguez-Galindo, MD, is also the co-director of our new Clinical and Translational Investigation Program, which aims to dramatically improve translational research in pediatric hematology and oncology.

    In addition to a variety of clinical trials, our researchers also conduct extensive laboratory research to identify new treatments and improve therapies for bone and soft tissue tumors.

    Read all about our innovative approach. 

     


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