Atypical presentation of an osteochondroma with vascular involvement in the popliteal fossa: A case report and review of the literature

Background: Osteochondroma is the most common benign bone tumour, typically arising from the metaphysis of long bones. While often asymptomatic, osteochondromas can rarely lead to potential vascular complications, particularly when located near the popliteal fossa. Case report: We present the case of a 22-year-old female with a six-months history of a painless swelling in the left popliteal fossa, which later became painful with symptoms of intermittent claudication. Radiological imaging was suggestive of a proximal tibial osteochondroma causing significant compression of the popliteal artery. The patient underwent successful en-bloc excision of the tumour via a posterior approach to the knee, without the need for vascular surgery. Postoperative recovery was uneventful, with restoration of distal pulses and full resolution of symptoms. We also reviewed the literature and summarised various vascular complications related to osteochondromas around the knee. Conclusion: Popliteal artery compression due to osteochondroma is an uncommon cause of intermittent claudication, particularly in young patients without atherosclerotic risk factors. Early recognition and timely surgical intervention are critical to prevent irreversible vascular damage. Definitive management typically involves surgical excision of the osteochondroma, often accompanied by vascular repair or reconstruction to restore adequate blood flow.