Vol. 9, Issue 3, Part A (2025)

Introduction: Osteochondroma is the most common benign bone tumor and typically arises from the metaphyses of long bones. Pelvic locations are uncommon, and involvement of the iliac wing is particularly rare. Because of its proximity to neurovascular structures and pelvic organs, this location may be a source of significant discomfort despite the benign nature of the lesion.
Case presentation: We report the case of a 14-year-old boy who presented with a slowly enlarging swelling over the right iliac region, responsible for mechanical discomfort when wearing trousers and pain in the lateral decubitus position. Clinical examination revealed a firm, non-inflammatory mass fixed to the iliac wing, without neurological or vascular deficits. Pelvic radiographs demonstrated a broad-based sessile bony outgrowth in continuity with the cortex and medullary canal of the ilium, consistent with a solitary osteochondroma. In view of the symptoms and lesion size, en bloc resection was performed through an approach centered on the iliac crest. Histopathological analysis confirmed a benign osteochondroma with a hyaline cartilage cap and no signs of malignancy. The postoperative course was uneventful. At five-year follow-up, the patient was asymptomatic, with no functional limitation and no radiological evidence of recurrence.
Conclusion: Solitary osteochondroma of the iliac wing is an uncommon but important differential diagnosis for pelvic bone masses in adolescents. When symptomatic, complete surgical excision is a simple and effective treatment, providing excellent long-term outcomes.