Pedunculated Osteochondroma of Inferior Pubic Ramus: A Report of a Rare Case

Osteochondromas are the most common benign bone tumours, which usually manifest as bony projections covered with a cartilaginous cap and originate from the metaphysis of long bones. However, they can create discomfort and difficulties, particularly in non-traditional places, although they are frequently asymptomatic. An osteochondroma arising from the right inferior pubic ramus is a rare case. A 31-year-old gentleman presented with an enlarged swelling in the right groin for 17 years, giving him great discomfort, difficulty in performing sexual activities, irritation, and aesthetic issues. The swelling was insidious in onset, firm and non-pliable, measuring 15 x 11 cm, and gradually progressive over the years. It displaced the scrotum and was fixed to the underlying bone. This pedunculated bone growth arising from the right inferior pubic ramus was identified by plain X-ray, pelvic anteroposterior and lateral view, and computed tomography imaging. An excisional biopsy was performed on the patient using the femoribus internus perineal approach. The tumour was carefully removed piecemeal using an osteotome. After surgery, radiographs confirmed complete removal. This case study demonstrates the effective application of the femoribus internus perineal approach and excision technique. There was a resolution of symptoms, and no symptom recurrence was noted after surgery. This case illustrates the importance of tailored surgical methods for managing osteochondromas in non-traditional locations.