Surgical excision of a solitary osteochondroma arising from the lesser trochanter in an adult: a case report

Authors

  • Swapnil Keny Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India
  • Aditya Dahapute Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India
  • Swapneel Shah Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India
  • Nandan Marathe Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203738

Keywords:

Osteochondroma, Exostosis, Proximal femur, Lesser trochanter

Abstract

The occurrence of osteochondroma around the proximal femur is rarely reported as most cases are asymptomatic. We report a rare case of symptomatic solitary osteochondroma arising from the lesser trochanter in a skeletally mature patient causing significant impairment of hip function managed by surgical excision. A 32-year-old male labourer presented with pain and swelling over right hip region for nine months. Radiographic examination (X-ray, MRI, CT) revealed the pathognomonic continuity of the cortex and medulla of the lesion with the parent bone. Cartilage cap cover (measuring 15 mm) on MRI helped to clinch the diagnosis. CT guided biopsy was also suggestive of osteochondroma. The tumour was excised en bloc by posterior approach without the need for hip dislocation. The base of the lesser trochanter was osteotomised and the entire mass with the cartilage cap was removed. A two year follow up has shown no evidence of local recurrence. Surgical excision of a symptomatic osteochondroma is a successful form of treatment with low mortality. Adequate pre-operative radiographic examination is helpful to know the location and local spread of the tumour. Measurement of cartilage cap thickness on MRI is an essential tool to diagnose malignant changes. A safe and adequate resection should be carried out in an effective manner with attention to femoral head vascularity and prevention of local recurrences. Patients with solitary osteochondroma around the proximal femur should be kept under observation to help early detection of malignant changes.

Author Biographies

Swapnil Keny, Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India

Assistant Professor Dept of Orthopaedics Seth G.S. Medical College and K.E.M Hospital

Aditya Dahapute, Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India

Assistant Professor, Department of Orthopaedics,

K.E.M hospital and Seth GSMC, Mumbai, Maharashtra 400012.

Swapneel Shah, Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India

Senior resident, Department of Orthopaedics,

K.E.M hospital and Seth GSMC, Mumbai, Maharashtra 400012

Nandan Marathe, Department of Orthopaedics, K. E. M. Hospital and Seth GSMC, Mumbai, Maharashtra, India

Senior resident, Department of Orthopaedics,

K.E.M hospital and Seth GSMC, Mumbai, Maharashtra 400012.

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Published

2020-08-26