J Korean Foot Ankle Soc.  2014 Mar;18(1):36-39. 10.14193/jkfas.2014.18.1.36.

Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve

Affiliations
  • 1Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. hohotoy@nate.com
  • 2Department of Pathology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Abstract

Tarsal tunnel syndrome is defined as a compressive neuropathy of the posterior tibial nerve in the tarsal canal. Schwannoma is a benign tumor that arises from the peripheral nerve sheath. It presents as a discrete, often tender, and palpable nodule associated with neurogenic pain or paresthesia when compressed or traumatized. The growth rate is usually slow, and these lesions seldom exceed 2 cm in diameter. In addition, local recurrence occurs less than 5%. We report on a case of tarsal tunnel syndrome caused by a large recurred space-occupying lesion measuring 4.3x2.7x2.7 cm3.

Keyword

Tarsal tunnel syndrome; Schwannoma; Neurilemmoma; Recurrence

MeSH Terms

Neurilemmoma*
Paresthesia
Peripheral Nerves
Recurrence
Tarsal Tunnel Syndrome*
Tibial Nerve*

Figure

  • Figure 1. The sagittal (A) and coronal (B) sonogram shows an oval shaped well-defined hypoechoic mass with inhomogeneous echo texture. (C) Color-coded Doppler scan shows flow signals in the mass.

  • Figure 2. Sagittal T2-weighted magnetic resonance imaging image with high signal intensity on the total mass without target sign.

  • Figure 3. Intraoperative finding of mass arising from posterior tibial nerve.

  • Figure 4. A well circumscribed, encapsulated, multilobulated, solid mass revealed diffusely myxoid and homogenously grayish yellow cut surfaces.

  • Figure 5. (A) Histological features exhibit neurogenic, spindle cell proliferation with biphasic pattern of growth and prominent nuclear palisading (H&E stain, ×100). (B) Spindle tumor cells express diffuse strong immunoreactivity for S-100 protein (×200).


Cited by  1 articles

Update on Management of Compressive Neuropathy: Tarsal Tunnel Syndrome
Hak Jun Kim, Gyu-Sun Jang, Jiho Lee
J Korean Orthop Assoc. 2014;49(5):340-345.    doi: 10.4055/jkoa.2014.49.5.340.


Reference

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