Treatment of adamantinoma of femur with limb preservation. A case report and review of the literature

Abstract Background Adamantinoma is a rare lesion of low-grade malignancy, and represents 1% of malignant bone tumours of bones, and is mainly located in two regions of the body, jaw (ameloblastoma), and lower extremities. The treatment of choice is surgery due to it being a radio- and chemotherapy-resistant neoplasia. Clinical case A 39-year-old male with a history of neonatal hydrocephalus with moderate psychomotor retardation. He began with pain in the posterior region of the left thigh for one year before admission, which was managed as posterior radicular syndrome. He had sudden intense pain on walking that led him to fall over. In the examination, left pelvic limb with deformity in the distal third with increase in volume in the thigh, with pain to palpation, and presence of crackles in the distal third of the femur were observed. A biopsy of the thigh was performed, with subsequent local wide excision + replacement of bone with cadaver bone and a central medullary nail. The final diagnosis was adamantinoma of femur. Conclusion Adamantinomas are rare tumours. It is important to recognise this type of tumour from the beginning, since its prognosis is excellent in initial stages. It is important to have free margins as survival is very high.