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青少年近端胫腓关节巨大滑膜囊肿导致的腓总神经卡压性神经病变

Common Peroneal Nerve Compression Neuropathy Due to a Large Synovial Cyst From the Proximal Tibiofibular Joint in a Teenager.

作者信息

Khalefa Mohamed A, Hussain Shakir, Bache Edwards C

机构信息

Trauma and Orthopedics, The Royal Orthopedic Hospital, Birmingham, GBR.

Trauma and Orthopedics, Cairo University, Cairo, EGY.

出版信息

Cureus. 2023 Oct 6;15(10):e46562. doi: 10.7759/cureus.46562. eCollection 2023 Oct.

Abstract

Ganglion cysts are very rare in the lower limb and when present, ganglion cysts rarely cause compression neuropathy at any site. Peripheral nerve sheath tumors as a whole, are also very rare and mostly presented as a painful lump along the nerve path. Ganglion cysts are non-neoplastic gelatinous cysts, which lack true synovial lining. They can be divided into intraneural cysts which can be found within the epineurium of a peripheral nerve and lead to signs and symptoms of peripheral neuropathy or extraneural cysts which can develop from surrounding joints or tendon sheaths causing gradual nerve compression. Intraneural tumors of common peroneal nerve (CPN) are widely reported in the literature with varying degrees of symptoms; however, there are only a few case reports describing CPN palsy due to extraneural cysts. We are reporting a rare case of atraumatic CPN palsy, which resulted in irreversible foot drop in a teenage boy who presented with right leg radiating calf and foot pain. We recommend prompt investigation and excision of the cyst to decompress the nerve to increase the chances of early recovery and favorable outcomes.

摘要

腱鞘囊肿在下肢非常罕见,即便出现,腱鞘囊肿在任何部位都很少引起压迫性神经病变。总体而言,周围神经鞘瘤也非常罕见,大多表现为沿神经路径的疼痛性肿块。腱鞘囊肿是无肿瘤性的胶冻样囊肿,缺乏真正的滑膜内衬。它们可分为神经内囊肿,可在周围神经的神经外膜内发现,并导致周围神经病变的体征和症状,或神经外囊肿,可从周围关节或腱鞘发展而来,导致逐渐的神经压迫。文献中广泛报道了腓总神经(CPN)的神经内肿瘤,症状程度各异;然而,仅有少数病例报告描述了由神经外囊肿导致的CPN麻痹。我们报告了一例罕见的非创伤性CPN麻痹病例,该病例导致一名十几岁男孩出现不可逆的足下垂,他表现为右腿小腿和足部放射性疼痛。我们建议对囊肿进行及时检查和切除,以解除神经压迫,增加早期恢复和良好预后的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc47/10625661/eb30dae6579a/cureus-0015-00000046562-i01.jpg

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