Right Proximal Humerus Osteochondroma in a Child

This case demonstrates a proximal humerus osteochondroma in a 12-year-old male patient presenting with visible medial arm swelling. Surgical planning was important because the lesion was large and close to major neurovascular structures in the medial arm.

Age / sex12-year-old male patient

Side / siteRight proximal humerus; medial aspect

Main complaintProgressive medial proximal arm swelling

Final diagnosisOsteochondroma

Anatomical concernLarge medial projection close to important vessels and nerves

Imaging workupPlain radiographs and 3D CT reconstruction

Case summary

Clinical assessment and imaging showed an exophytic bony lesion arising from the medial aspect of the proximal right humerus. Plain radiographs and 3D CT reconstruction demonstrated a large osteochondroma projecting toward the medial arm.

The final diagnosis was osteochondroma. Because of the lesion size and anatomical location, surgical management required careful dissection and protection of the surrounding neurovascular structures.

Why specialist assessment matters

Many osteochondromas are benign lesions, but symptoms, size, growth behavior, pain, neurovascular proximity, and imaging features determine whether observation or surgery is more appropriate. In children, evaluation should also consider skeletal maturity and the relationship of the lesion to nearby growth regions and soft tissues.

Clinical and radiographic documentation

The following de-identified, logo-watermarked images show the clinical swelling, preoperative X-rays, 3D CT planning images, and postoperative radiographs.

Clinical photograph showing visible medial proximal arm swelling in a child with proximal humerus osteochondroma — Figure 1. Clinical photograph showing visible swelling along the medial aspect of the proximal arm. The face and identifying details are excluded.

Preoperative AP radiograph showing proximal humerus osteochondroma projecting from the medial right humerus — Figure 2. Preoperative AP radiograph showing an exophytic bony lesion arising from the medial aspect of the proximal right humerus.

Preoperative oblique radiograph showing size and medial projection of proximal humerus osteochondroma — Figure 3. Preoperative oblique view demonstrating the size and medial projection of the proximal humerus osteochondroma.

Preoperative lateral radiograph showing morphology of proximal humerus osteochondroma — Figure 4. Additional radiographic view showing lesion morphology and relation to the proximal humerus.

Additional preoperative radiograph showing exophytic proximal humerus osteochondroma morphology — Figure 5. Additional preoperative radiograph highlighting the broad-based exophytic morphology of the lesion.

3D CT reconstruction showing proximal humerus osteochondroma and medial projection — Figure 6. 3D CT reconstruction showing the proximal humerus osteochondroma and its medial projection.

Oblique 3D CT reconstruction clarifying proximal humerus osteochondroma anatomy — Figure 7. Oblique 3D CT reconstruction clarifying the spatial relationship between the lesion and proximal humerus.

Close 3D CT reconstruction showing lobulated exostotic component of proximal humerus osteochondroma — Figure 8. Close 3D CT reconstruction demonstrating the lobulated exostotic component.

Postoperative AP radiograph showing internal stabilization after surgical management of proximal humerus osteochondroma — Figure 9. Postoperative AP radiograph showing internal stabilization/fixation after surgical management.

Postoperative oblique radiograph confirming fixation position after proximal humerus osteochondroma surgery — Figure 10. Postoperative oblique radiograph confirming fixation/stabilization position after surgery.

Clinical learning points

The final diagnosis in this case was osteochondroma.
No malignant diagnosis is stated in this website case summary.
Medial proximal humerus lesions require careful planning because of nearby vessels and nerves.
Treatment decisions depend on clinical examination, complete imaging, lesion behavior, and operative findings.

FAQ

Is osteochondroma usually benign?

Osteochondroma is commonly benign, but each case should be assessed according to symptoms, growth behavior, imaging appearance, and anatomical risk.

Why was CT useful in this case?

3D CT helped clarify the shape, size, and direction of the lesion and its relationship to the proximal humerus, which supports operative planning.

Can an osteochondroma be close to nerves and vessels?

Yes. Depending on location and projection, an osteochondroma can be close to important neurovascular structures, especially in the medial arm.

Does every osteochondroma need surgery?

No. Management is individualized. Observation may be suitable in selected cases, while surgery may be considered for symptoms, size, risk to nearby structures, or concerning clinical features.

Medical disclaimer: This case is presented as educational content for a specialist orthopedic oncology case library. It does not replace clinical examination, imaging review, or individualized medical advice.

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