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Osteochondroma - pubic ramus

Case contributed by Adesola Asaleye
Diagnosis almost certain

Presentation

Non-increasing painless right groin mass of over 40 years.

Patient Data

Age: 60 years
Gender: Female

Pelvis

x-ray

A pedunculated bony outgrowth of the medial aspect of the right superior pubic ramus. Its medullary cavity is continuous with that of the underlying bone. This is indicative of osteochondroma.

Pelvis

ct

There is a pedunculated bony exostosis with chondroid components arising from the anterior cortex of the right superior pubic ramus. It shows intramedullary continuity with that of the underlying bone. No discrete associated soft tissue mass is demonstrated. This is indicative of an osteochondroma. 

Case Discussion

Osteochondroma is the commonest benign bone tumor. According to the WHO classification, This lesion is defined as a cartilage-capped bony projection arising on the external surface of a bone containing a marrow cavity that is continuous with that of the underlying bone.

It occurs in 3%of the population and accounts for more than 30%of all benign bone tumors. Solitary osteochondromas show a predilection for the metaphyses of the long tubular bones, especially the femur(30%), humerus (26%) and tibia (43%). Rare sites are in the carpals, tarsals, patella, sternum, pelvis and spine.

Osteochondromas are usually asymptomatic and found incidentally. The usual symptoms are painless, slow-growing mass on the involved bone. The clinical signs of malignancy are pain, swelling and an enlargement of the mass.

The diagnosis requires radiological depiction and in some cases, particularly in suspicion of malignancy, histological examination is also needed. The clinical signs of malignancy are not present in this case.

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