Osteochondroma: is it always easy to face with?
A case series of difficult removals
Case report, 163 - 167Tag this article
Osteochondroma (OC) is the most frequent benign bone tumor. Symptomatic lesions, aesthetic issues and the suspect of malignant transformation are the main indications for surgical treatment. In this paper we describe some rare cases of osteochondromas that required particular attention in order to reduce the risk of complications. We discuss four cases: an OC giving compression of sciatic nerve, an OC causing a false aneurysm of the humeral artery, an OC arising from a risky position on the distal femur that required a double surgical access and a symptomatic OC in the fibula that compressed both anterior and posterior tibial vasculo nervous bundle. OC is usually managed with conservative treatment and follow up. Surgical excision is performed when the lesion is at strict contact with vascular or nervous structures becoming symptomatic or when it starts growing during the adult age. Surgery often becomes a very challenging due to position, dimensions and mostly for the closeness to vascular and nervous structures. The treatment of these “difficult exostoses” must be planned carefully and often with a multidisciplinary approach.
KEY WORDS: osteochondromas; exostoses; benign tumor; surgical excision