A solitary osteochondroma of the scapula.

To cite: Vaishya R, Dhakal S, Vaish A. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013202273 DESCRIPTION Osteochondromas (exostosis) are commonly found benign tumours (35–46%) of the bone. 2 These are mostly found in the metaphyseal region of long bones and the scapula is involved rarely in 3–4.6% of cases. These scapular tumours may present with winging of the scapula. We present a case of an 18-year-old male with a large, symptomatic osteochondroma of the scapula. He presented with a painless deformity of the right scapula for the past 3 years. Local examination revealed winging of the right scapula (figure 1) and a bony prominence at the medial border of the right scapula. Terminal abduction of glenohumeral joint was restricted. An X-ray of the chest revealed a bony outgrowth from the medial margin of the right scapula. A CT scan revealed an anteriorly directed bone growth at superomedial portion of the scapula, measuring 5.2×2.9×3.2 cm (figures 2–4). A bony hard tumour (5×3 cm) was excised in toto (figure 5) from the right scapula under general anaesthesia, by a longitudinal incision parallel to the medial scapular border. Histology confirmed the diagnosis of osteochondroma with no evidence of malignancy (figure 6). The patient’s deformity disappeared completely and he had full range of glenohumeral and scapulothoracic movements at 3 months, postoperatively. The growing potential of osteochondromas usually ends by the time of closure of growth plate (physis), and if the growth continues into adulthood, it should alarm the surgeon for possible malignancy.