Kim Dongbin, Choi Jin-Gyu, Son Byung-Chul
Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1225-1228. doi: 10.4103/ajns.AJNS_6_17.
Intraneural ganglion cysts are rare mucinous cysts originating within the epineurium of peripheral nerves. Although ganglion cysts are the most frequent tumors of the upper and lower extremities, ganglion cysts rarely result in peripheral nerve compression. We report a case of a 30-year-old patient who presented with foot drop due to subparaneurial ganglion cyst, a variant of an intraneural ganglion cyst. Characteristic magnetic resonance imaging findings were essential in the preoperative diagnosis of intraneural ganglion cyst. The common peroneal nerve and its branches were recognized and traced to its bifurcation during the operation. The articular branches were addressed. The mucious content of the ganglion was typically found to be located within the subparaneurial compartment. Incision of the subparaneurial ganglion cyst was performed, and mucinous content was evacuated. At 2 months after the surgery, paralyzed peroneal nerve was recovered completely. Therefore, early diagnosis of intraneural ganglion, precise identification of the pathology, and proper treatment of the articular branch with atraumatic dissection of ganglion cyst are essential in the successful management of this rare lesion.
神经内腱鞘囊肿是起源于周围神经神经外膜的罕见黏液囊肿。虽然腱鞘囊肿是上肢和下肢最常见的肿瘤，但腱鞘囊肿很少导致周围神经受压。我们报告一例30岁患者，因神经旁腱鞘囊肿（神经内腱鞘囊肿的一种变体）出现足下垂。特征性磁共振成像表现对神经内腱鞘囊肿的术前诊断至关重要。术中识别并追踪腓总神经及其分支直至其分叉处。处理关节支。腱鞘囊肿的黏液性内容物通常位于神经旁间隙内。切开神经旁腱鞘囊肿并清除黏液性内容物。术后2个月，麻痹的腓总神经完全恢复。因此，神经内腱鞘囊肿的早期诊断、病理的精确识别以及腱鞘囊肿的无创伤性分离对关节支进行适当治疗，对于成功处理这种罕见病变至关重要。
