Popliteal artery pseudoaneurysm associated with osteochondroma

A 15-year-old boy developed pain and swelling in the right popliteal fossa after jumping rope. The pain and swelling exacerbated during the next 2 weeks, and he was admitted to our hospital. On physical examination, a 3-cm bluish pulsatile mass was found in the right popliteal fossa, which was painful on palpitation. Neurologic compromise was not evident, and distal pulses were palpable. Plain radiography revealed an osteochondroma arising from the distal femoral shaft. A computed tomography scan revealed a 3.53.02.5-cm popliteal artery pseudoaneurysm, which was closely associated with the spiky spur that was the most probable cause of the perforation of the popliteal artery (A , B, and Cover). Surgery was performed the next day; the popliteal artery was exposed by an anteromedial approach. A 3-cm false aneurysm cavity was found arising from a defect on the anterolateral aspect of the popliteal artery (C), coinciding with a spike of fibular osteochondroma. After the vascular clamps were applied proximally and distally, the pseudoaneurysm was opened. A 2-mm-diameter hole was found in the anterolateral aspect of the popliteal artery. Aneurysmectomy and reconstruction using reversed great saphenous vein was performed, and the bony spike was excised. The patient made an unremarkable recovery and was discharged after 11 postoperative days.