Although ganglion cysts occur frequently, their presence in the lower extremities is rare and they seldom cause peripheral nerve compression. There are enumerable case reports of intraneural ganglion involvement with the common peroneal nerve and its branches, the sural nerve, and the posterior tibial nerve but extraneural ganglion sciatic and common peroneal nerve palsy cases are quite rare. Our case, a 26 years old female patient presented with right leg tingling and radiating pain followed up gradually with progressive right sided foot drop. MRI diagnosed the lesion as a ganglion cyst and the EMG/NCV confirmed the level of compression at the right fibular head. The patient was electively operated with standard lateral approach and the ganglion cyst engulfing the common peroneal nerve was excised. The cyst was traced to the base of its articular origin, excised and stalk ligated to prevent recurrence. At 1 year, there were no signs of recurrence and the patient was symptomatically free with no residual weakness. We, thus, report to you a rare cause of common peroneal nerve palsy-a proximal tibio-fibular joint "ganglion cyst"; a cause of foot drop which can be completely reversible if treated appropriately, its implications and thus, making its early diagnosis significant.
Paraganglioma is a neuroectodermal tumour which originates from the chromaffin cells. Paraganglioma of spinal cord is uncommon lesion and usually presents as intradural tumour within cauda equina. We present a case of 42 year old female having spinal paraganglioma which developed in lumbar segment of spinal cord. The patient complained the pain in lower back and both legs with sensory deficit in left lower limb. Preoperative MRI showed a intradural mass. Patient operated with laminectomy and durotomy with complete excision of mass. Histopathology and Immunohistochemistry study showed the Zellaballen pattern and positive markers for Viamentin, Synaptophysin, Chromogranin A and Neurone specific enolase. Paraganglioma is a rare tumor with recurrence potential so total precision excision is the best option to achieve cure and to reduce the chance of recurrence.
Background: Intra-spinal oxidized cellulose-induced post-operative paraplegia has been a rare but devastating complication and has been variedly reported. This is one of the common hemostatic agent used and invariably left in-situ. However, oxidized cellulose is associated with the peculiar chemical property to swell and cause pocket-compression, especially in confined areas, which may recover but can also cause an everlasting complete/ partial neurological deficit. Case Report: Our patient, a 68 year old female operated for a D3-D5 level meningioma developed post-surgical acute-onset paraplegia. An immediate post-operative MRI, urgent re-exploration and meticulous decompression resulted in complete neurological recovery at six months post-operatively. Conclusion: We, thus, present this unusual but well-documented oxidized cellulose related complication and make an attempt to highlight and suggest some basic teaching points.
Introduction: The Ewing family of tumors comprises Ewing's sarcoma (EWS), extraskeletal EWS, primitive neuroectodermal tumor (PNET) of bone and soft tissue, and chest wall tumor (Askin tumor). The translocation t(11; 22) (q24; q12) is identified in more than 90% of cases.EWS is the second most common primary bone malignancy in childhood. In contrast to long bone involvement, delays in spinal EWS diagnosis may occur because symptoms may not be present until neurological deficits occur. To date, although there have been reported cases of EWS in the lumbosacral region, the reported cases are very less and the presentations might drastically differ. Case Presentation: A 14 year old boy comes with a 12 weeks h/o urinary incontinence and constipation. Over the next 4 months, the patient had new-onset intermittent abdominal pain with worsening urinary symptoms.MRI confirmed a diagnosis of Koch's spine. However, the histopathology reported it as an "Ewings sarcoma/Primitive Neuroectodermal Tumor". Discussion: Ewing's tumor of sacrum is rare, but should be suspected in low backache in children. Cauda equina syndrome can be a valid presentation for EWS spine. MRI can identify cases early and enables early treatment though it is not specific. Histopathological diagnosis is a must before any definitive management.EWS spine can mimick Tuberculosis both clinico-radiologically, only to be confirmed with a tissue biopsy. Conclusion: Ewing's sarcoma of the lumbosacral spine can have an atypical presentation and there should be a high degree of suspicion to diagnose it early.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.