Osteochondroma of Dorsal Spine: A Rare Clinical Entity

Osteochondroma is the most common benign bone tumor, typically affecting the appendicular skeleton. Its occurrence in the spine, particularly the dorsal region, is rare. Although often asymptomatic, spinal osteochondromas can present with neurological symptoms when they compress adjacent neural elements. Early diagnosis and management are critical to prevent complications, including malignant transformation.

We present the case of a 14-year-old female who reported a progressively enlarging, painless swelling over the upper left back for 6 months. Physical examination revealed a firm, non-tender, non-mobile mass measuring approximately 5 × 5 cm, without any associated neurological deficits. Magnetic resonance imaging suggested osteochondroma. There was no family history of similar complaints, ruling out hereditary multiple exostoses. The lesion was surgically excised en bloc, and the bony base was cleared using a nibbler to minimize recurrence. Histopathological analysis confirmed the diagnosis of osteochondroma. Post-operative recovery was uneventful, and the patient remained asymptomatic during follow-up.

Spinal osteochondroma, particularly in the dorsal spine, is a rare presentation. Although often clinically silent, progressive growth warrants surgical intervention to avoid potential complications. Gross total resection, including removal of the cartilage cap, is recommended to prevent recurrence and reduce the risk of malignant transformation. This case highlights the importance of clinical vigilance and imaging in diagnosing and managing atypical osteochondromas.