Singh Sidhant, Singh Roop, Tanwar Milind, Kaur Kiranpreet
Department of Orthopaedics, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Department of Anaesthesia, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
J Orthop Case Rep. 2020;10(2):5-8. doi: 10.13107/jocr.2020.v10.i02.1672.
Ganglion cysts are benign cystic tumors of musculoskeletal structures which have variable clinical presentations, however, compression neuropathies due to ganglion cyst are much less common in the lower extremity and only a couple of cases have been described in the literature. Hence, in the current case report, we describe a patient with a giant ganglion cyst causing peroneal nerve palsy which was managed surgically.
A 50-year-old female presented with a 2-month history of progressive left foot drop with a gradual development of swelling over the left fibular head. Imaging suggested ganglion cyst-induced peroneal nerve palsy. Initial conservative treatment failure warranted surgical excision which confirmed extraneural origin on histopathological examination. An immediate clinical improvement was observed postoperatively and full recovery occurred within 6 months. There was no recurrence at 2 years follow up.
The ganglion cyst-induced compression neuropathies are uncommon in lower limbs, especially in a skeletally mature person. Our case was an extraneural cyst which is the rare comparatively. The possibilities of other differentials should be excluded through imaging due to non-specific presentations. Surgical management is the preferred mode of treatment with 10% recurrences which can be reduced by complete excision including stalk.
腱鞘囊肿是肌肉骨骼结构的良性囊性肿瘤，临床表现多样，然而，腱鞘囊肿导致的压迫性神经病变在下肢较为少见，文献中仅描述了少数病例。因此，在本病例报告中，我们描述了一名因巨大腱鞘囊肿导致腓总神经麻痹并接受手术治疗的患者。
一名50岁女性，有2个月渐进性左足下垂病史，左侧腓骨头处肿胀逐渐加重。影像学检查提示腱鞘囊肿导致腓总神经麻痹。最初的保守治疗失败后进行了手术切除，组织病理学检查证实为神经外起源。术后立即观察到临床症状改善，6个月内完全恢复。随访2年无复发。
腱鞘囊肿导致的压迫性神经病变在下肢不常见，尤其是在骨骼成熟的人群中。我们的病例是神经外囊肿，相对罕见。由于表现不具特异性，应通过影像学检查排除其他不同诊断的可能性。手术治疗是首选的治疗方式，复发率为10%，通过完整切除包括囊肿蒂部可降低复发率。
