Osteochondroma of femoral neck: a rare cause of sciatic nerve compression

Abstract

<p>Osteochondroma is most common primary benign bone tumor and comprising of more than one-third of primary benign bone tumors. Osteochondromas are usually extra-articular lesions secondary to their common origin from metaphysis of long bones. Osteochondroma of the femoral neck is atypical as they represent an intra-articular lesion. They are mostly asymptomatic depending on their size and location. We are describing a rare cause of sciatic nerve compression in an adult which turned out to be solitary osteochondroma of femoral neck. 18 years old man reported to us with complains of pain in left groin region, mass in buttock region associated with tingling sensations in left lower limb since 8 months. Patient complains of difficulty in sitting on hard surface. Sensation was decreased on plantar and dorsal aspect of left foot. A sessile mass measuring 6 x 4 cm on posterior femoral neck was seen on plain radiographs and CT. Electromyography showed moderate sciatic neuropathy of the peroneal and tibial branches. Surgical en-bloc resection was performed through posterior approach. The final pathological report indicated the tumor was an osteochondroma. Post-operatively symptoms resolved dramatically. At follow up, he had full resolution of neurologic findings. Postoperatively, the patient reported improvement in numbness and tingling in the leg. So we should have awareness and high index of suspicion of rare entities such as proximal femur osteochondroma during diagnosis and treatement of sciatic neuropathy along with other more common etiology. </p>