VASCULAR LESIONS IN THE LOWER LIMBS CAUSED BY OSTEOCHONDROMAS

Introduction. The most common bone tumour is osteochondroma (OC). It may be found in both sporadic solitary or multiple forms, and characteristically affects the long bones of the lower limbs while the individual is still growing. It is usually asymptomatic but as it grows it may injure vascular structures, giving rise to ruptures and the formation of pseudoaneurysms. In the medical literature to date, the most numerous series consisted of six patients with vascular lesions due to this kind of tumour. Aim. To report and analyse our experience on four cases of this sort of vascular complications produced by OC. Patients and methods. In all cases the popliteal artery was involved. Case 1: male, 16 years old, multiple OC and a five-day history of arterial rupture; case 2: male, 9 years old, sporadic OC and a one-month history of pseudoaneurysm; case 3: male, 17 years old, sporadic OC and a one-month history of giant pseudoaneurysm; case 4: female, 19 years old, sporadic OC and an 11-months' history of pseudoaneurysm. Arterial reconstruction was performed with a vein patch in three cases and direct suturing in one case. Results. There were no recurrences of OC in cases 1 and 2, which were subject to long follow-ups. Pathological analysis confirmed the tumours were benign in all cases. Post-operative progress was favourable and patients were soon discharged from hospital. Conclusions. This condition needs to be ruled out when dealing with pain in the lower limbs in teenagers, due to the frequency of these tumours, especially if OC is known to have existed previously. An imaging study is important with arterial reconstruction before surgery. OCs growing towards vascular pathways must be excised as a preventive measure, even though they are asymptomatic.