Solitary Pubic Osteochondroma Presenting With Sexual Discomfort in a Young Adult Male: A Case Report.

We report the case of a young adult male in his early twenties who presented with a gradually enlarging swelling in the right groin extending to the base of the penis, associated with discomfort during erection, and pain after prolonged sitting. Clinical examination revealed a firm, immobile bony swelling in the pubic region. Radiographs and MRI demonstrated a large bony lesion measuring approximately 60 × 73 × 53 mm arising from the right pubic bone and inferior pubic ramus, with continuity of the cortex and medulla and a cartilage cap measuring about 9.6 mm. The lesion was closely abutting the penile base but without surrounding soft tissue edema. Histopathological examination of a core biopsy confirmed an osteochondroma without malignant features. The patient underwent complete excision of the mass using Ludloff's approach, including removal of the cartilaginous cap. He resumed walking on the first postoperative day and remained symptom-free at one-year follow-up, with no evidence of recurrence. This case highlights a rare presentation of solitary pubic osteochondroma manifesting as sexual discomfort in a young adult male. It underscores the importance of clinical suspicion, detailed imaging for characterization and surgical planning, and timely excision to achieve symptom relief and prevent long-term complications.