A rare large solitary osteochondroma of the left iliac wing in a 36-year-old Somali woman: a case report

Osteochondroma is a common benign bone tumor; however, pelvic involvement, particularly arising from the iliac wing, is uncommon. Such lesions may remain asymptomatic for years or present with vague mechanical symptoms, making diagnosis challenging. A 36-year-old Somali woman presented with a two-year history of intermittent left hip and pelvic pain radiating to the left lower limb. The lesion had initially been detected incidentally during pelvic imaging performed following hysterosalpingography. Three-dimensional computed tomography demonstrated a large exophytic osseous mass arising from the outer table of the left iliac wing and projecting laterally from the pelvis. No other exostoses were present. Because the lesion was large, symptomatic, and functionally limiting, surgical excision was performed in the supine position using an osteotome. Histopathological examination showed woven bone trabeculae containing marrow elements, mature hyaline cartilage lobules, and a fibrous capsule, with no evidence of malignancy; the findings were reported as suggestive of osteochondroma, and correlation with the exophytic imaging appearance established the diagnosis. The postoperative course was uneventful, with good wound healing, symptom improvement, no neurological deficit, and no early evidence of recurrence. Large solitary osteochondroma of the iliac wing is a rare presentation. This case highlights the importance of combining clinical assessment, three-dimensional imaging, surgical excision, and radiological–pathological correlation for accurate diagnosis and effective management of unusual pelvic osteochondromas.