Management of Scapular Osteochondroma: An Uncommon Report of Two Cases.

Introduction: Osteochondroma is the most common benign bone tumor, accounting for approximately 35-40% of all benign skeletal neoplasms. Although commonly seen in the metaphysis of long bones, involvement of the scapula is uncommon. Scapular osteochondromas may present with pain, cosmetic deformity, mechanical restriction of shoulder movement, snapping scapula syndrome, or scapular winging. Symptomatic lesions often require surgical excision. Case Report: We report two cases of symptomatic dorsal scapular osteochondroma in young adult males. The first patient, a 27-year-old male with a family history of multiple hereditary exostosis, presented with a giant swelling arising from the right scapula associated with pain and restricted shoulder movements. The second patient, a 25-year-old male, presented with a progressively enlarging swelling over the left scapula causing mechanical restriction of shoulder abduction. Radiographs, computed tomography, and magnetic resonance imaging confirmed the diagnosis in both cases. Complete surgical excision was performed through a posterior approach. Histopathological examination confirmed benign osteochondroma in both patients. At 6-month follow-up, both patients demonstrated complete symptom resolution, full range of motion, and no evidence of recurrence. Conclusion: Scapular osteochondroma should be considered in the differential diagnosis of posterior shoulder swellings and unexplained mechanical shoulder symptoms in young adults. Cross-sectional imaging is essential for diagnosis and surgical planning. Complete excision of symptomatic lesions results in excellent functional outcomes and minimal recurrence risk.