Paediatric Pedunculated Dorsal Osteochondroma of the Scapula: A Medical Oddity with Review of Literature.

Introduction: Encountering osteochondroma of the scapula is an oddity in clinical practices amid its incidence of 14.4% of all tumors of scapula. It is also noteworthy that the majority of osteochondromas arise from the ventral surface of the scapula, whereas only a few reported cases originate from the dorsal surface, with these lesions typically presenting as the sessile variant. The purpose of this case report is to reveal the clinicopathological and radiological presentation along with the surgical exposure of dorsal scapular osteochondroma of pedunculated morphology in a pediatric age group. Case Report: We report a case of 8-year-old male patient who presented with the complaints of abnormal painless hard swelling over the right side of the upper back since last 5 years, which was gradually progressive in nature. It was associated with discomfort in lying supine position and inability to take turn toward right side. On examination, swelling measured approximately 4 × 3 cm in size. Roentgenographic examination revealed bony outgrowth from the dorsomedial aspect of the right scapula. Computed tomography scan revealed a pedunculated stalked mushroom-like mass arising from the dorsal surface at the medial border of the scapula. Patient underwent en block excisional biopsy, which on histopathology turned to be osteochondroma. Conclusion: Although the dorsal scapular region is a very rare location for osteochondroma to occur, especially in pediatric population, its clinical manifestation is not uncommon, that is, "the mass effect." Patient's presentation is largely guided by the morphology and location of the tumor; therefore, meticulous history and examination are necessary to correlate the symptoms with the location of the tumor. Proper investigation is pivotal in identifying the appropriate surgical corridor, which should respect as much soft tissue as possible.