p63 expression in adamantinoma

Adamantinoma is a rare primary bone neoplasm with epithelial differentiation that is frequently associated with a concomitant fibrous component. Clinical, cytogenetic and histomorphologic overlap has previously been described with osteofibrous dysplasia, thereby suggesting a relationship between these two lesions. We performed a retrospective review of our archives to characterize the clinical and pathologic aspects of adamantinoma and osteofibrous dysplasia diagnosed at our institution, and to compare the expression patterns of p63 and keratin. Nine cases of adamantinoma (six classical, three osteofibrous dysplasia-like) and 11 cases of osteofibrous dysplasia were identified. The epithelial component in adamantinoma was found to stain for p63. Rare cells expressing p63 were also identified in eight cases of osteofibrous dysplasia. Expression of p63 was not identified in any of the five cases of fibrous dysplasia controls. The presence of staining for p63, albeit rare, in osteofibrous dysplasia supports the notion of a possible relationship between osteofibrous dysplasia and adamantinoma. Furthermore, our results suggest that, in some situations, p63 may be useful in helping differentiate metastatic carcinoma from adamantinoma.