Abstract
Ganglia affecting the peripheral nerves of the foot and ankle are rare. The most frequent
location of occurrence is the common peroneal nerve at the level of the fibular neck.
We report the case of an intraneural ganglion of the superficial peroneal nerve and
its branches. Although there have been many previous reports of intraneural ganglion
involvement with the common peroneal nerve, deep peroneal nerve, sural nerve, and
the posterior tibial nerve, to our knowledge, this is the first reported occurrence
of an intraneural ganglion distinctly localized to the superficial peroneal nerve
and its branches. The presumptive diagnosis was made preoperatively using magnetic
resonance imaging, and then confirmed postoperatively by pathologic examination. Despite
the use of operative magnification, it was impossible to remove all of the cyst elements
within the nerve trunk, because the nerve fascicles were intimately intertwined. Therefore,
complete resection of the common trunk of the superficial peroneal nerve and its terminal
branches was performed, and the proximal stump was buried in a hole in the distal
fibula. Two years after the surgery, the patient was pain free and asymptomatic except
for cutaneous anesthesia in the distribution of the superficial peroneal nerve.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Tibial intraneural ganglia in the tarsal tunnel: Is there a joint connection?.J Foot Ankle Surg. 2007; 46: 27-31
- Two cases of ganglia in the sheath of the peroneal nerve.Acta Orthop Scand. 1932; 2: 221-230
- Nerve sheath ganglion of the ulnar nerve.Arch Orthop Trauma Surg. 2000; 120: 108-109
- Sural neuropathy by intraneural ganglion.J Foot Surg. 1990; 29: 231-232
- Tarsal tunnel syndrome secondary to intraneural ganglion.J Neurol Neurosurg Psychiatry. 1989; 52: 1014-1015
- Intraneural ganglion: a case report with electron microscopic observations.Neurosurgery. 1981; 8: 487-490
- Tarsal tunnel syndrome caused by epineural ganglion of the posterior tibial nerve: report of 2 cases and review of the literature.J Foot Ankle Surg. 2004; 43: 185-190
- Ganglion cyst involvement of peripheral nerves.J Neurosurg. 1997; 87: 403-408
- Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory.J Neurosurg. 2003; 99: 330-343
- Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying theory.J Neurosurg. 2007; 107: 296-307
- Tarsal tunnel syndrome: an unusual case resulting from an intraneural degenerative cyst.Can J Surg. 1995; 38: 371-373
- Benign cystic lesions of peripheral nerves.Int Orthop. 1988; 12: 269-271
- Ganglia of the nerve. Presentation of two unusual cases, a review of the literature, and a discussion of pathogenesis.Clin Orthop. 1975; 113: 135-144
- A posttraumatic, joint connected sural intraneural ganglion cyst with a new mechanism of intraneural recurrence: a case report.J Foot Ankle Surg. 2008; 47: 199-205
- Magnetic resonance imaging of a deep peroneal intraneural ganglion cyst originating from the second metatarsophalangeal joint: a pattern of propagation supporting the unified articular (synovial) theory for the formation of intraneural ganglia.J Foot Ankle Surg. 2009; 48: 80-84
Article info
Publication history
Published online: May 31, 2010
Footnotes
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of Defence of the Hellenic Government.
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
