Dr. Aibin B Michael, Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India. E-mail: aibinmichael357@gmail.com
Introduction: Osteochondroma is the most common benign bone tumor, accounting for 20–50% of all benign bone tumors and typically arising from the metaphyses of long bones. Osteochondromas arising from flat bones such as the ilium are exceedingly rare, representing <5% of all osteochondromas. We report a rare case of a large solitary osteochondroma originating from the posterior-inferior part of the left iliac bone in a young female.
Case Report: We report a 21-year-old female with a solitary osteochondroma arising from the posteroinferior part of the left iliac bone. The lesion measured 4.3 × 2.7 × 2.5 cm with a cartilage cap thickness of 2.2 mm. Two magnetic resonance imaging (MRI) scans performed 1 year apart demonstrated an increase in lesion size, while the thickness of the cartilage cap remained unchanged. Surgical subperiosteal excision was performed using a vertical incision. The mass was removed with an osteotome, and bone wax was applied to the raw bone surface for hemostasis. Histopathological examination confirmed a benign osteochondroma without atypical features. At follow-up, the patient reports complete satisfaction with the resolution of deformity and no recurrences.
Discussion: Pelvic osteochondromas are rare and often present late due to their deep location. This case highlights a symptomatic flat-bone osteochondroma presenting with mechanical and cosmetic complaints. MRI findings supported a benign nature. Complete marginal excision, including the cartilage cap, is curative and minimizes recurrence risk.
Conclusion: This case emphasizes the rare location of osteochondroma in the iliac bone and demonstrates that timely surgical management can lead to excellent cosmetic and functional outcomes without recurrence. Early recognition and complete excision are key to successful treatment of flat-bone osteochondromas and prevention of complications.
Keywords: Osteochondroma, Iliac bone, Flat bone tumor, Pelvic osteochondroma, Surgical excision, Cartilage cap.
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