Endoscopy-Assisted Resection of Neurilemmoma of the Tibial Nerve at the Distal Leg

Abstract

Neurilemmoma of the tibial nerve at the distal leg is a deep-seated tumor, and diagnosis can be delayed for several years. The purpose of this Technical Note is to describe the technique of endoscopy-assisted resection of neurilemmoma of the tibial nerve at the distal leg. This minimally invasive approach can minimize soft-tissue dissection and may reduce the risk of postoperative perineural fibrosis.

Endoscopic En-Bloc Resection of Neurilemmoma of the Foot Dorsum

“…In comparison with the microscopic view, endoscopic visualization could achieve a better differentiation between the tumor mass and its capsule. 4 , 21 However, the nerves at the foot dorsum are small, intracapsular resection may not be possible, and injury to the nerve fascicles may not be avoidable. The patient should be well informed about this risk.…”

“… 2 , 3 It can involve any nerve of the foot and ankle. 1 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 These tumors are usually asymptomatic unless an increase in size or disruption of the nerve causes pain. 6 , 9 The symptoms of neurilemmoma on the foot and ankle are mainly related to pressure effects on the associated nerve (weakness and paresthesia) or pressure areas (e.g., at the sole).…”

“…Extreme care needs to be taken to dissect the tumor from associated nerves to preserve or restore nerve functions to a maximal level. 4 Recurrence is extremely rare unless the tumor tissue is incompletely excised. 1 Traditionally, the tumor is resected by an open approach.…”

“…Recently, techniques of endoscopic-assisted resection of the neurilemmoma have been reported. 4 , 17 , 18 , 19 This technical note describes the technique of endoscopic en-bloc resection of neurilemmoma of the foot dorsum. This is indicated for symptomatic neurilemmoma of the foot dorsum.…”

Endoscopic En-Bloc Resection of Intra-Muscular Lipoma of the Flexor Digitorum Profundus: A Uniportal Technique

“… 13 , 14 , 15 , 18 , 21 Endoscopic en-bloc tumor resection has been advocated to obtain a whole block specimen for histological examination. 13 , 14 , 17 , 22 , 23 , 24 , 25 , 26 , 27 The purpose of this technical note is to describe the details of endoscopic en-bloc resection of intramuscular lipoma of the flexor digitorum profundus. It is indicated in case of symptomatic well-circumscribed lipoma of the flexor digitorum profundus, especially for a growing tumor.…”