Solitary osteochondroma of the left scapula in an adolescent male: a rare case report

Abstract

Osteochondroma is the most common benign bone tumor; however, involvement of the scapula is uncommon. Scapular osteochondromas may present with swelling, painless, no restricted shoulder movements, snapping scapula, or pseudo-winging, often mimicking neuromuscular causes. We report a case of a 14-year-old male who presented with a gradually progressive swelling over the left scapular region for 5-6 months, associated with pseudo-winging. On examination, a bony hard, non-tender swelling fixed to the scapula was noted, without neurovascular deficit. Radiographs revealed a bony exostotic lesion arising from the left scapular blade. The patient underwent complete surgical excision through a posterior approach. Histopathological examination confirmed osteochondroma, demonstrating a cartilage cap with underlying trabecular bone and marrow elements. At 1-month follow-up, the patient showed satisfactory wound healing, significantly improved shoulder function, and resolution of pseudo-winging, with no evidence of early complications or recurrence. Scapular osteochondroma is a rare cause of pseudo-winging in adolescents and should be considered in the differential diagnosis of scapular asymmetry. Careful clinical and radiological evaluation helps differentiate it from true neuromuscular winging. Complete surgical excision provides excellent symptomatic relief and favorable functional outcomes.