Spontaneous Regression of Multiple Osteochondromas in a Patient With Hereditary Multiple Exostoses: A Case Report

TL;DR

A boy with hereditary multiple exostoses experienced spontaneous regression of painful bone tumors without surgery, suggesting conservative management can be effective.

Contribution

This case report highlights spontaneous regression of symptomatic osteochondromas in HME, supporting conservative treatment before growth plate closure.

Findings

An 11-year-old boy with HME showed spontaneous regression of osteochondromas by age 15.

Symptoms resolved without surgery, indicating potential for natural lesion regression during growth.

Conservative management is viable before physeal closure, based on lesion clinical course.

Abstract

Hereditary multiple exostoses (HME) is an autosomal dominant disorder characterized by the development of multiple osteochondromas, primarily near the metaphyses of long bones. We report a case of HME in which multiple symptomatic lesions showed spontaneous regression. The patient was an 11-year-old boy with osteochondromas involving both distal femurs and the left forearm. At age 13, he developed discomfort and pain during squatting and forearm rotation, and radiographs revealed progressive enlargement of the lesions. Given that the physes remained open, we chose a conservative approach. At age 15, the symptomatic lesions had regressed significantly, and his symptoms resolved without surgical intervention. This case demonstrates that even symptomatic lesions in HME may regress spontaneously during growth, supporting the value of conservative management before physeal closure. Surgical decisions should be guided by the clinical course of the lesion rather than its morphology or transient symptoms.

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