A solitary giant osteochondroma of the femur in the shape of a devil's head pushing back the superficial femoral artery: Case report and literature review

The most common benign bone tumors are osteogenic exostoses or osteochondromas. They occur during growth and are rarely the cause of vascular or nervous complications. We present the case of a young 34-year-old patient who consulted for a swelling in his right thigh. The X-ray revealed a giant, exuberant bony tumor in the lower third of the femur. The CT angiography allowed us to see the repression of the superficial femoral artery without interfering with blood flow. By resecting a giant tumor resembling a devil's head, the obstacle on the vascular structures was removed. Histology confirmed the diagnosis of solitary osteogenic exostosis. The patient made a complete recovery and there has been no recurrence after one year of follow-up. A solitary femoral diaphysis exostosis causing arterial compression is a rare complication. Resection and relief of artery compression should be considered early, before serious vascular sequelae develop, which can be irreversible and result in amputation. Better recognition and more comprehensive evaluation of these rare cases should be emphasized. •Giant and solitary osteogenic exostoses are uncommon, and their treatment depend on the location and complications.•Solitary femoral diaphysis exostosis causing vascular compression are rare, and adequate surgical care should be considered early, before the onset of serious vascular damage that can be irreversible and lead to amputation.