Case report
Solitary osteochondroma of the capitate, in a child

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Abstract

Osteochondromas, are the most common tumors of the long bones in children. Osteochondromas are extremely rare in the carpal bones. They are diagnosed in adult life, in almost all cases in the literature. We report a 7 year old boy, who presented with a hard mass on the dorsum of his hand, with decreased wrist movements. Radiological examination showed a calcified tumor of the second row of the carpal bones, with spherical shape and covered with cartilage. He was surgically treated with removal of a cartilaginous mass that was arising from the capitate. Pathology confirmed the diagnosis of an osteochondroma.

Introduction

Osteochondromas, although being the most common tumors of the musculosceletal system, are extremely rare in carpal bones. Only sporadic cases have been reported for solitary osteochondromas arising from carpal bones. Lesions involving the scaphoid, the capitate, the lunate, the hamate and the trapezoid have been reported.1, 2, 3, 4, 5, 6, 7, 8, 9 Although osteochondromas are benign tumors of children, in almost all cases in the literature, osteochondromas of the carpal bones are discovered in adult age. There is only one, recently published, case report of an exostosis of the hamate, in a child.10

We report a 7 year old boy, with a solitary osteochondroma of the capitate. He was surgically treated, after a thorough clinical and radiological investigation. We want to draw attention for an extremely rare condition, a benign tumor in the hand of a child.

Section snippets

Case report

A 7 year old boy presented with a hard swelling on the dorsum of his left hand. The patient had noticed a difference in the range of movements of his left wrist compared to the right one, while training in swimming. The restriction of wrist movements had occurred during the last year, but the patient and his parents noticed the difference in the shape of his hand just a few weeks before examination. The boy had never complained of pain in the wrist.

On clinical examination, a distinct

Discussion

Osteochondromas or exostoses are benign bone tumors. Usually they present as painless hard mass near joints, on the metaphyseal region of long bones.

Very few cases of solitary osteochondromas of the carpal bones have been reported in the literature. They describe solitary osteochondromas of the scaphoid, the lunate, capitate, hamate and the trapezoid.1, 2, 3, 4, 5, 6, 7, 8, 9

Decreased range of motion and a hard mass on the wrist are the main symptoms from such lesions of the carpal bones. It is

Conclusion

Solitary exostoses of the carpal bones are very rare and usually identified in adult life. We present a unique case of a child with a painless swelling on the dorsal aspect of the wrist, that was a solitary osteochondroma of the capitate. Surgical treatment with excision of the lesion resulted in full recovery of the patient and complete restoration of the patient’s arc of wrist motion.

Conflict of interest

None.

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