Osteochondroma of the Distal Femur in Young Patient: An Oncology Case Report


  • Komang Septian Sandiwidayat Oncology Division, Department of Orthopaedic & Traumatology, Sanglah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia


Background: Osteochondroma is the most common primary bone tumor manifested as a painless, slow-growing mass. Apart from its asymptomatic manifestations, the tumor is malignant potential so appropriate management needs to be acknowledged. The aim of this study is to discuss the possible clinical findings for diagnosing with managing this rare case properly, which may provide a good outcome for this patient.

Case Presentation: A 17-year-old male presented with a chief complaint of a slow-growing lump on the back of his right thigh. On physical examination, a 7 cm x 6 cm mass with mild tenderness was found during palpation. Based on these clinical and imaging findings, we informed and gained consent from the patient for surgery followed by a histopathology examination. The histopathology examination confirmed osteochondroma in the right distal femur.

Results: Surgery was performed to curatively remove the tumor, followed by a histopathological examination which confirmed the diagnosis of osteochondroma. One week after the surgery, the post-surgical wound care was performed showing an excellent result, without any signs of infection or complications.

Conclusion: Typical manifestation of painful osteochondromas may be associated with mechanical compression to the surrounding nerve and vascular structures. Surgical excision is an appropriate management approach to provide consistent relief of pain and deformity in osteochondroma case.

Keywords: arteriovenous malformations, CT scan, rare case, embolization

Correspondence: Komang Septian Sandiwidayat. Oncology Division, Department of Orthopaedic & Traumatology, Sanglah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. Email: drseptianortho@gmail.com. +62-821-4725-2042.

Indonesian Journal of Medicine (2022), 07(01): 82-88


Alyas F, James SL, Davies AM, Saifuddin A (2007). The role of MR imaging in the diagnostic characterisation of appendicular bone tumours and tumourlike conditions. Eur Radiol. 17(10): 2675–2686. DOI: 10.1007/s003300070597y.

Bottner F, Rodl R, Kordish I, Winklemann W, Gosheger G, Lindner N (2003). Surgical treatment of symptomatic osteochondroma. A three to eightyear followup study. J Bone Joint Sr. 85(8): 1161–1165. DOI: 10.1302/0301620X..14059.

Florez B, Mönckeberg J, Castillo G, Beguiristain J (2008). Solitary osteochondroma longterm followup. J Pediatr Orthop B. 17(2): 91–94. DOI: 10.1097/BPB.0b013e3282f450c3.

Gavanier M, Blum A (2017) Imaging of benign complications of exostoses of the shoulder, pelvic girdles and appendicular skeleton. Diagn. Interven. Imaging. 98(1): 21–28. DOI: 10.1016/j.diii.2015.11.021.

Hassankhani EG (2009). Solitary lower lumbar osteochondroma (spinous process of L3 involvement): a case report. Cases Journal. 2(1): 9359. DOI: 10.1186/1757162629359.

Jeevannavar SS, Shenoy KS, Baindoor P, Shettar CM (2013). Giant osteochondroma lower end of femur A case report. IOSR – JDMS. 4(1):133.

Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, Bai M (2008). Osteochondromas: review of the clinical, radiological and pathological features. In vivo. 22(5): 633–46.

Maheshwari AV, Jain AK, Dhammi IK (2006). Extraskeletal paraarticular osteochondroma of the knee—a case report and tumor overview. The Knee 13(5): 411–414. DOI: 10.1016/j.knee.2006.05.008.

Mnif H, Koubaa M, Zrig M, Zammel N, Abid A (2009). Peroneal nerve palsy resulting from fibular head osteochondroma. Orthopedics. 32(7): 528. DOI: 10.3928/014774472009052724.

Motamedi K and Seeger LL (2011). Benign Bone Tumors. Radiol Clin North Am. 49(6): 1115–1134. DOI: 10.1016/j.rcl.2011.07.002.

Passanise AM, Mehlman CT, Wall EJ, Dieterle JP (2011). Radiographic Evidence of Regression of a Solitary Osteochondroma. J Pediatr Orthop. 31(3): 312–316. DOI: 10.1097/BPO.0b013e31820fc676.

Raherinantenaina F, Rakotoratsimba HN, Rajaonanahary TMA (2016). Management of extremity arterial pseudoaneurysms associated with osteochondromas. Vascular. 24(6): 628–637. DOI: 10.1177/1708538116634532.

Salgia A, Biswas S, Agarwal T, Sanghi S (2013). A rare case presentaion of osteochondroma of scapula. Med. J. Dr. D.Y. Patil Univ. 6(3): 338. DOI: 10.4103/09752870.114673.

Singh R (2012). Large paraarticular osteochondroma of the knee joint: a case report. Acta Orthop Traumatol Turc. 46(2): 139–143. DOI: 10.3944/AOTT.2012.2542.

StitzmanWengrowicz ML, PretellMazzini J, Dormans JP, Davidson RS (2011). Regression of a Sessile Osteochondroma: A Case Study and Review of the Literature. University Of Pennsylvania Orthopaedic Journal 21:736.

Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, Kanavaros P, Kitsoulis P (2021). Osteochondromas: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features and Treatment Options. In Vivo.

(2): 681–691. DOI: 10.21873/invivo.12308.

Tristano AG, Hernández L, Villarroel J, Millan A (2006). Coexistence of osteochondroma and reactive arthritis. Mod Rheumatol. 16(5): 332–333. DOI: 10.3109/s1016500605124.