Vascular complications of tibial exostosis: A case of popliteal vein thrombosis

Abstract

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.

Keywords: Osteochondroma; Popliteal artery occlusion; Popliteal vein thrombosis; Treatment, Tibial exostosis.

Fig. 1

Radiographic image showing exostosis on the posterior aspect of the proximal tibia.

Fig. 2

CT 3D reconstruction and Angiography CT imaging illustrating close relationships with popliteal vessels and resulting arterial and venous compression.

Fig. 3

Image depicting the posterior knee approach during exostosectomy based on the Triquet method.

Fig. 4

The exostosis after excision.