Osteochondroma or osteocartilaginous exostosis is one of the most common benign tumors of the bone. Causes for the disease are yet unknown, but there are indications that they may be linked to abnormality in the growth plate and possibly mutation in EXT1, EXT2 and EXT3 genes. Cases of reported osteochondromas range from prehistoric to contemporary examples, are not limited geographically, and no evidence for sex predominance has been reported.

Here we present a unique case of large pedunculated-type osteochondroma on the right fibula of an adult female skeleton from the medieval site of Ilok-Krstbajer in eastern Croatia. In order to gain more insight into this pathological change we used holistic approach consisting of a combination of techniques that have not been used previously in the analysis of neoplasms from archaeological settings.

The cauliflower-shaped growth is 50 mm long in sagittal and 57.41 mm in transverse diameter with the tumor exhibiting a bulbous, rough superior surface, and a flat, smoother inferior surface. The gross morphology of the tumor together with radiological and histopathological features support the diagnosis of a proximal fibular osteochondroma making it the first such case in an archaeological population. Based on archaeological context and similar clinical cases it seems that the presented osteochondroma did not have major impact on the life-quality of a woman affected by this pathology. The procedure used in this study is minimally invasive and highly accurate, and as such sets new analytical criteria for studies of ancient bone neoplasms.

骨软骨瘤或骨软骨外生骨疣是最常见的骨良性肿瘤之一。该病的病因尚不清楚，但有迹象表明它们可能与生长板的异常有关，并可能与 EXT1、EXT2 和 EXT3 基因的突变有关。报告的骨软骨瘤病例从史前到当代不等，不受地域限制，也没有报告性别优势的证据。

在这里，我们在克罗地亚东部的中世纪遗址 Ilok-Krstbajer 的成年女性骨骼的右侧腓骨上展示了一个独特的大型带蒂型骨软骨瘤病例。为了更深入地了解这种病理变化，我们使用了整体方法，该方法由以前在考古环境中的肿瘤分析中未使用的技术组合组成。

花椰菜状生长的矢状面长 50 毫米，横向直径 57.41 毫米，肿瘤呈现球茎状、粗糙的上表面和平坦、更光滑的下表面。肿瘤的大体形态以及放射学和组织病理学特征支持对腓骨近端骨软骨瘤的诊断，使其成为考古人群中的首例此类病例。根据考古学背景和类似的临床病例，所呈现的骨软骨瘤似乎对受这种病理影响的女性的生活质量没有重大影响。本研究中使用的程序是微创和高度准确的，因此为古代骨肿瘤的研究设定了新的分析标准。