Paediatric osteofibrous dysplasia-like adamantinoma with classical radiological findings

A 16-year-old girl presented with a 1-month history of a painful lump on the right tibia. There was no history of trauma; she had no medical conditions and was physically active. On examination, she had a diffuse bony lump in the middle third of the right tibia with some localised tenderness. There was no neurovascular deficit and no bony masses were present elsewhere. Plain radiograph of the right leg (figure 1) showed a well-circumscribed, slightly expansile, mixed sclerotic and lytic lesion of the anterior diaphysis of the right tibia. The sclerosis and lysis were seen as a multilocular ‘soap bubble’ appearance. No aggressive features including periosteal reaction or soft-tissue abnormality were present. A subsequent MRI scan confirmed the presence of an extensive lesion involving the anterior cortex of the midshaft of the right tibia, extending a vertical distance of 20 cm. The lesion appeared confined to the cortical bone, …