Cargando…

Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report

INTRODUCTION: Although ganglion cysts are common soft tissue tumors, nerve compression syndrome caused by a ganglion cyst in the lower extremities is very rare. Herein, we report a 57-year-old man who presented with hypoesthesia in the sole of his right foot for 6 months. We believe that reporting t...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Shinkyoung, Kim, Hyeungjune, Jo, Dong In, Na, Sang-Jun, Jo, Yoon-Sik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773471/
https://www.ncbi.nlm.nih.gov/pubmed/29274601
http://dx.doi.org/10.1016/j.ijscr.2017.12.016
_version_ 1783293564200943616
author Kim, Shinkyoung
Kim, Hyeungjune
Jo, Dong In
Na, Sang-Jun
Jo, Yoon-Sik
author_facet Kim, Shinkyoung
Kim, Hyeungjune
Jo, Dong In
Na, Sang-Jun
Jo, Yoon-Sik
author_sort Kim, Shinkyoung
collection PubMed
description INTRODUCTION: Although ganglion cysts are common soft tissue tumors, nerve compression syndrome caused by a ganglion cyst in the lower extremities is very rare. Herein, we report a 57-year-old man who presented with hypoesthesia in the sole of his right foot for 6 months. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of the plantar neuropathy, and avoid diagnostic delay. PRESENTATION OF CASE: The patient had pain and numbness in the inner right sole, as well as a tingling and dull sensation. Tenderness around the area of abnormal sensation was not evident. Percussion at the abductor tunnel gave a positive Tinel’s sign in the medial plantar nerve. No mass was palpable in the right foot. Based on the electrophysiological findings, we diagnosed medial plantar nerve entrapment in the right foot. Magnetic resonance imaging (MRI) was conducted to identify a 5.5-cm long elongated cystic lesion as the cause of entrapment. The patient underwent surgical removal of the cystic mass, with histologic examination confirming the diagnosis of a large ganglion cyst. DISCUSSION: The feasibility of nerve conduction studies and electromyography for detection of nerve entrapment is still controversial. MRI is considered the best diagnostic modality, if biopsy is not feasible. CONCLUSION: We suggest that foot imaging and electrophysiological studies should be considered for patients with isolated median plantar neuropathy to exclude the presence of space-occupying lesions, especially when conservative treatment is not effective.
format Online
Article
Text
id pubmed-5773471
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-57734712018-01-29 Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report Kim, Shinkyoung Kim, Hyeungjune Jo, Dong In Na, Sang-Jun Jo, Yoon-Sik Int J Surg Case Rep Article INTRODUCTION: Although ganglion cysts are common soft tissue tumors, nerve compression syndrome caused by a ganglion cyst in the lower extremities is very rare. Herein, we report a 57-year-old man who presented with hypoesthesia in the sole of his right foot for 6 months. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of the plantar neuropathy, and avoid diagnostic delay. PRESENTATION OF CASE: The patient had pain and numbness in the inner right sole, as well as a tingling and dull sensation. Tenderness around the area of abnormal sensation was not evident. Percussion at the abductor tunnel gave a positive Tinel’s sign in the medial plantar nerve. No mass was palpable in the right foot. Based on the electrophysiological findings, we diagnosed medial plantar nerve entrapment in the right foot. Magnetic resonance imaging (MRI) was conducted to identify a 5.5-cm long elongated cystic lesion as the cause of entrapment. The patient underwent surgical removal of the cystic mass, with histologic examination confirming the diagnosis of a large ganglion cyst. DISCUSSION: The feasibility of nerve conduction studies and electromyography for detection of nerve entrapment is still controversial. MRI is considered the best diagnostic modality, if biopsy is not feasible. CONCLUSION: We suggest that foot imaging and electrophysiological studies should be considered for patients with isolated median plantar neuropathy to exclude the presence of space-occupying lesions, especially when conservative treatment is not effective. Elsevier 2017-12-12 /pmc/articles/PMC5773471/ /pubmed/29274601 http://dx.doi.org/10.1016/j.ijscr.2017.12.016 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Kim, Shinkyoung
Kim, Hyeungjune
Jo, Dong In
Na, Sang-Jun
Jo, Yoon-Sik
Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title_full Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title_fullStr Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title_full_unstemmed Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title_short Isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with MRI: A case report
title_sort isolated medial plantar neuropathy caused by a large ganglion cyst diagnosed with mri: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773471/
https://www.ncbi.nlm.nih.gov/pubmed/29274601
http://dx.doi.org/10.1016/j.ijscr.2017.12.016
work_keys_str_mv AT kimshinkyoung isolatedmedialplantarneuropathycausedbyalargeganglioncystdiagnosedwithmriacasereport
AT kimhyeungjune isolatedmedialplantarneuropathycausedbyalargeganglioncystdiagnosedwithmriacasereport
AT jodongin isolatedmedialplantarneuropathycausedbyalargeganglioncystdiagnosedwithmriacasereport
AT nasangjun isolatedmedialplantarneuropathycausedbyalargeganglioncystdiagnosedwithmriacasereport
AT joyoonsik isolatedmedialplantarneuropathycausedbyalargeganglioncystdiagnosedwithmriacasereport