Posterior Tibial Nerve Schwannoma Presenting as Tarsal Tunnel Syndrome

Jha, Aaradhana J.; Basetty, Chandan R; Viner, Gean C.; Tedder, Chandler; Shah, Ashish

doi:10.7759/cureus.5303

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…The usual symptoms begin with ankle pain, swelling, painful walking and plantar foot pain while standing, as well as a burning sensation and numbness. Tarsal tunnel syndrome can be caused by benign tumors -like schwannomas - (Jha et al, 2019), perineural fibrosis, varicosities, osteophytes, traumas and postoperative scarring (Neary et al), while the presence of supernumerary structures at the tarsal tunnel can also lead to this syndrome as well.…”

Section: Discussionmentioning

confidence: 99%

Supernumerary Muscles in the Posterior Leg Compartment: a Case Report

et al. 2022

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The leg muscles are organized in anterior, lateral and posterior compartments. The posterior compartment is usually divided in two layers: superficial and deep. The deep muscles of the posterior compartment of the leg are known to mainly plantar flexion and toes flexion. In comparison to the other leg compartments, variations of the posterior one are rare. These variants often involve the presence or absence of one or more muscles, and they have differences among origin and insertion, which leads to confusion between anatomists. We aim to describe a case of a male cadaver that possessed three supernumerary muscles in the lateral and posterior compartments of both legs: the peroneus quartus muscle and two accessory bellies of the flexor digitorum longus. This presentation seems to be very rare and scarcely reported in the literature. These variants have the potential of causing nervous or vascular compression, thus leading to tarsal tunnel syndrome or a symptomatic peroneus quartus. The clinical and surgical implications of this abnormal presentation is discussed.

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Section: Discussionmentioning

confidence: 99%

Supernumerary Muscles in the Posterior Leg Compartment: a Case Report

et al. 2022

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“…Various studies in the literature reported that schwannomas are common in the anterior and flexor areas of the upper extremities and the posterior aspects of the lower extremities [ 12 , 13 ]. The review of lower extremity schwannoma from 2013 to 2020 is tabulated in [ Table 1 ] [ 10 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Tibial Nerve Schwannoma: An Unexplained Cause of Lateral Foot Pain – A Rare Case Report and Review

Kumar¹,

Ranjan²,

Jeyaraman³

et al. 2020

JOCR

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Introduction: 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. Case Report: We report the case of a schwannoma arising from the tibial nerve located in the left popliteal fossa. The patient presented with the left foot pain in the lateral plantar region without any motor deficit. The pre-operative diagnosis was made with magnetic resonance imaging (MRI) scan. He was subjected for neurolysis and excision biopsy of the lesion. The surgical specimen consisted of encapsulated white-yellow mass with irregular contours, measuring 2 × 3 cm. The cut section revealed cystic degenerations with areas of hemorrhage and necrosis. The patient reported symptom free in the post-operative period and during follow-up. Marginal excision appears to be recommended therapy for this tumorous lesion, without any evidence of recurrence during follow-up. Conclusion: A benign nerve sheath tumor of a peripheral nerve could be a possibility for long-standing neuropathic pain in the foot, ankle, and leg, wherein all other possibilities have been ruled out. The meticulous examination of the entire length of the tibial nerve including sciatic nerve by palpation and percussion was helpful in diagnosis which should be confirmed by MRI scan. The excision biopsy remains the gold standard treatment of choice for schwannoma of the peripheral nerve.

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“…A Schwannoma tumour located in the posterior tibial nerve in the tarsal tunnel is extremely rare [1][2][3][4][5][6][7][8][9][10], and hence surgery of this pathology also occurs rarely. Schwannoma within the foot, causing pain syndrome, requires differentiation from Morton's metatarsalgia [11].…”

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confidence: 99%