Recurrent ganglion cyst of the peroneal nerve: Radiological and operative observations - Case report
Recurrent ganglion cyst of the peroneal nerve: Radiological and operative observations - Case report
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DOI：
10.3171/jns.1996.84.2.0280
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发表时间：
1996-02-01
影响因子：
4.1
通讯作者：
Stevenaert, A
中科院分区：
文献类型：
--
作者：
Dubuisson, AS;Stevenaert, A
34岁男性，表现为右腿疼痛和足下垂，持续1个月。术前诊断10厘米长的腓神经神经节囊肿是通过超声（US），计算机断层扫描，特别是磁共振（MR）成像实现的。手术探查发现一个分叶状囊性肿块，充满胶状物质，与腓深神经的神经物质混合。病变被完全切除，牺牲了一些无电功能的神经束。未发现与膝关节有关。术后运动功能恢复良好。然而，常规术后磁共振成像显示复发神经节囊肿，其范围略小于原始。对膝关节进行了仔细的放射检查，包括关节造影术。囊肿与胫腓骨关节的连接清晰可见，并在再次手术时被小心地关闭。患者的术后过程平安无事，在再次手术5个月后获得的第三张MR图像显示没有囊肿复发的迹象。患者术后11个月无症状。本病例说明了US和MR在诊断成像中的价值。本文描述了超声和磁共振成像在识别和表征神经节囊肿方面的诊断效果。神经节囊肿与胫腓骨关节之间的密切接触应提高现有囊肿-关节通讯的可能性，并有助于积极的放射检查和/或手术寻找这种通讯。
This 34-year-old man presented with right leg pain and foot drop of 1-month duration. The preoperative diagnosis of a 10-cm-long ganglion cyst of the peroneal nerve was achieved using ultrasonography (US), computerized tomography and, particularly magnetic resonance (MR) imaging. Surgical exploration disclosed a lobulated cystic mass filled with gelatinous material, which intermingled with the nerve substance of the deep peroneal nerve. The lesion was completely resected, with the sacrifice of some electrically nonfunctioning, fascicles. No connection with the knee joint was found. A good postoperative recovery of motor function was obtained. However, routine postoperative MR imaging disclosed a recurrent ganglion cyst that was slightly less extensive than the original. A careful radiological examination of the knee joint was performed, including arthrography. A communication of the cyst with the tibiofibular joint was clearly demonstrated and was meticulously closed at reoperation. The patient's postoperative course was uneventful, and a third MR image, obtained 5 months after reoperation, showed no sign of cyst recurrence. The patient remained free of symptoms 11 months postoperatively.This case illustrates the value of US and MR in diagnostic imaging. The diagnostic efficacy of US and MR imaging in identifying and characterizing a ganglion cyst is described. Close contact between a ganglion cyst and the tibiofibular joint should raise the possibility of an existing cyst-joint communication and lend to an aggressive radiological workup and/or a surgical search for such a communication.