Background: Exostosis is a relatively common benign bone tumor in young patients and is often asymptomatic, aside from the presence of a mass. In this presentation, we report a rare case of exostosis of the proximal tibia, which caused an occlusion of the popliteal artery and subsequent intermittent claudication, along with a discussion of relevant literature.

Case presentation: The patient was a 25-year-old man who had been aware of a mass in the right popliteal fossa since junior high school. He presented with intermittent claudication of the right lower limb and consulted the orthopedic surgery department at his previous hospital, where imaging studies revealed a suspected occlusion of the popliteal artery caused by an exostosis of the right proximal tibia. He was referred to our hospital for multidisciplinary treatment. We performed tumor resection and popliteal artery reconstruction with an autologous vein graft in collaboration with the orthopedic surgery department, and the postoperative course was uneventful.

Conclusion: We encountered a rare case of popliteal artery occlusion due to tibial exostosis. In cases of popliteal artery occlusion caused by tumors, both exostosis resection and revascularization are necessary.