A Heavy Burden on the Back: Surgical Excision of a Massive Scapular Osteochondroma – A Case Report

Introduction: Osteochondromas are the most common benign bone tumors, typically arising from the metaphyseal regions of long bones. However, their occurrence in flat bones, particularly the scapula, is rare. We report a case of a large solitary osteochondroma arising from the dorsal aspect of the scapula in a pediatric patient, which was successfully treated with surgical excision. Case Report: A 12-year-old female presented with a progressively enlarging bony swelling over the right scapular region since the age of 7 years, recently associated with difficulty in lying over the affected side. Radiological evaluation, including X-ray and computed tomography scan confirmed a large osteochondroma arising from the inferior angle of the right scapula. This case is unique as the osteochondroma extends from dorsal to ventral aspect through the lateral aspect of scapula making it difficult for the child to lie on both supine and right lateral positions. The patient underwent en bloc excision, resulting in complete resolution of symptoms and had no recurrence at follow-up. Conclusion: Though uncommon, osteochondroma should be considered in the differential diagnosis of bony swellings over flat bones, such as the scapula. Earlier surgical management may yield the best functional and cosmetic outcomes. Keywords: Osteochondroma, scapula, bony swelling, pediatric bone tumor, surgical excision.