Osteochondroma of the Distal Tibia in an Adolescent: A Case Report

Abstract

A 17-year-old male presented with a painful left ankle that had been worsening over the preceding 1 year. Clinical and radiographic inspection revealed marked bowing with a deformation of the fibula secondary to the laterally outgrowing bone lesion from the distal tibia proximal to the growth plate. MRI appearance suggestive of an osteochondroma of the lower extremity of the left tibia with signs of degeneration, It is surrounded by a cartilaginous cap, thickened in places, measuring 22 mm in maximum thickness. Although the radiographic characteristics of the lesion were indicative of osteochondroma, a typically asymptomatic and benign tumor that is usually identified as an incidental finding, the large size and symptoms associated with the lesion described in this article make it rather unusual. In this particular case, excessive bony outgrowth, pain, joint malposition, necessitated surgical intervention. The patient was successfully treated with resection of the tumor, after which gradual restoration of the alignment of the distal leg ensued without the need for fibular osteotomy. After more than 1 year of postoperative follow-up, neither radiographic nor clinical evidence of recurrence had been observed and the patient displayed a pain-free range of ankle motion without any physical limitations.