Spontaneous Regression of Multiple Osteochondromas in a Patient With Hereditary Multiple Exostoses: A Case Report

Hereditary multiple exostoses (HME) is an autosomal dominant disorder characterized by the development of multiple osteochondromas, primarily near the metaphyses of long bones. We report a case of HME in which multiple symptomatic lesions showed spontaneous regression. The patient was an 11-year-old boy with osteochondromas involving both distal femurs and the left forearm. At age 13, he developed discomfort and pain during squatting and forearm rotation, and radiographs revealed progressive enlargement of the lesions. Given that the physes remained open, we chose a conservative approach. At age 15, the symptomatic lesions had regressed significantly, and his symptoms resolved without surgical intervention. This case demonstrates that even symptomatic lesions in HME may regress spontaneously during growth, supporting the value of conservative management before physeal closure. Surgical decisions should be guided by the clinical course of the lesion rather than its morphology or transient symptoms.