Table 3.

Differences between Osteofibrous dysplasia and Adamantinoma

Features	Osteofibrous dysplasia	Adamantinoma
Nature	Benign condition	Locally aggressive
Age	Less than 10 years	2 year to 86 years
Site	May involve both tibia and fibula.	90% tibial involvement, In 10–15% cases, ipsilateral fibular involvement, Rarely pretibial soft tissue and other bones
Clinical presentation	• Pain, swelling, pseudoarthrosis, bowing, pathological fracture may occur	• With or without Pain, swelling, pathological fracture in 25% cases
	• seldom progresses during childhood, and any progression of the lesion stops after puberty	• progressive during adult age
Predisposing history of trauma	Absent	Present
Radiology	Periosteal reaction present	Periosteal reaction is variable
	Intra cortical	15% of cases, there is extracortical extension into soft tissues
	Limited to anterior cortex	Single or multiple nodular lesions in one or more foci in medulla
	Well marginated with marginal sclerosis, ground glass appearance	Sharply or poorly delineated osteolytic lesion. with septations and peripheral sclerosis, characteristic "soap-bubble" appearance
Histopathology	Zonal phenomenon present Scattered epithelial cells recognized on IHC	Absent Presence of epithelial cells forming small nests/strands recognized in H&E
Recurrence	Local recurrence in 25%.	Tends to recur in 18–32%
Metastasis	No metastasis	Metastases may occur in 15–30%, Lung and Lymph nodes usually involved
Regression	Spontaneous regression at puberty in 33% cases	Regression ± [45]