Schwannoma and neurofibroma of the posterior tibial nerve presenting as tarsal tunnel syndrome: review of the literature with two case reports

Posterior Tibial Nerve Schwannoma Presenting as Tarsal Tunnel Syndrome

“…To diagnose a schwannoma, a thorough examination of the patient’s clinical history and physical examination must be performed. Positive Tinel signs and dorsiflexion-eversion are two tests that may suggest the presence of a schwannoma of the posterior tibial nerve [6,8,11]. Addtionally, nerve conduction studies may indicate a schwannoma’s existence.…”

“…The biphasic presence of Antoni type A and Antoni type B cells comprise schwannomas and indicate its presence in histopathological analysis. Antoni type A tissue are dense and orderly arranged; in contrast, Antoni B tissue have fewer cells and disorganized areas [4,8].…”

The necessity to use microsurgical methods and intraoperative monitoring during pathology in tarsal tunnel. Technical report

“…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].…”

“…The slow growing process of a benign tumour in a narrow anatomical space causes the occurrence of symptomatic tarsal tunnel syndrome, which is an entrapment neuropathy of the tibial nerve [7][8][9]. Due to troublesome neurological symptoms, the patient is qualified for surgical peripheral schwannoma removal [1,[4][5][6][7][8][9][10]. The tibial nerve at the operated anatomical level participates in sensory innervation of the foot plantar side and motor innervation of the muscles responsible for movement of the toes within the plantar flexion, support, and foot arching in an upright position, and maintaining the foot arch.…”

“…These involve short and strong muscles, which are divided into three groups: medial, lateral, and intermediate eminence. A disturbance of the functions, disruption of innervation of these muscles, makes normal walking and sporting activities impossible [10,[16][17][18].…”