Multifocal adamantinoma simulating traumatic pathology on bone scanning

This is a case report of a young physically active patient who presented with pain in the right leg. Plain radiograph and bone scan showed lesions mimicking stress fracture. Follow-up investigations (repeated plain radiography and three phase bone scan) and histopathological examination proved it as a case of multifocal adamantinoma. This report signifies that physicians should not lock their mind only to one entity and keep the differential diagnosis list flexible especially if patient does not respond to a specific treatment. Tibial adamantinoma should also be considered in the differential diagnosis of stress fracture. Further, second lesion can occur in the rib cage defying the common belief that second lesion will be in the adjacent bone, fibula.