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

• Kim JY
• Lee HK
• Cho J

• KMID: 1958737
• DOI: http://doi.org/10.14193/jkfas.2014.18.1.36

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

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  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.

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

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

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

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  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).

Reference

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