Huge juxtaneural ganglion cyst of the tibial nerve: A case report and review of the literature
Summary Background Huge juxtaneural ganglion cyst of the tibial nerve is rare. Methods A 58 year old man presented with a 1 year history of vague numbness in the entire plantar area of the right foot. He complained of steady pain at the medial side of the right ankle. During examination, a painful and firm mass at the posteromedial aspect of the distal right leg was palpated. The mass extended down to the retromalleolar region. Magnetic resonance imaging showed a huge juxtaneural ganglion cyst of about 9 cm length compressing the tibial nerve. Results Meticulous microsurgical dissection and excision of the ganglion cyst was performed. The nerve was found flattened by the compressing mass without other morphological particularities. The origin of the ganglion was uncertain but probably linked to the upper ankle joint (posterior of the tibiotalar joint) At 32 months postoperative follow up, the patient was completely free of pain. Conclusions Even after a delayed diagnosis of 1 year, meticulous excision of an intraneural ganglion cyst in the limited space of the posteromedial neurovascular bundle of the ankle could result in a good outcome.