A Case Series of Intraneural Ganglion Cyst Involving the Common Peroneal Nerve: Potential Cause for Foot Drop

Background: Intraneural ganglion cysts (IGC) are non-neoplastic mucinous cysts that form when thick mucinous fluid accumulates in the epineurium of peripheral nerves, with the majority of cases occurring in the para-articular or articular areas. Case Presentation: The two cases of a 69-year-old man and a 59-year-old man who acquired peroneal nerve neuropathy as a result of an intraneural ganglion cyst are presented here. The L.L.R.M. Medical College Department of Orthopedics provided care for them. There was complete nerve recovery in all patients after substantial cyst wall dissection and secretion removal. Conclusion: An intraneural ganglion cyst and trauma may exacerbate nerve damage, despite the fact that it is difficult to detect the cyst before surgery. An early diagnosis and prophylactic actions are typically associated with better outcomes. KEY WORDS: Intraneural ganglion, Common peroneal nerve, Foot drop.

High-resolution MRI of a peroneal intraneural ganglion cyst arising from the knee joint: illustrative case

BACKGROUND The advancement of high-resolution imaging and increased clinical experience have led to an increased understanding of the formation and treatment of intraneural ganglion cysts. Nearly all intraneural ganglion cysts in the common peroneal nerve have been reported to arise from a joint connection to the superior tibiofibular joint. The authors have identified four cases of intraneural ganglion cysts arising from the knee joint itself; however, none of these reported cases were well described, documented, or illustrated with high-resolution imaging. OBSERVATIONS Here the authors present the case of an intraneural ganglion cyst arising from the knee joint and causing intermittent weakness and pain. The articular branch to the knee joint was clearly demonstrated on high-resolution magnetic resonance imaging and confirmed at surgical exploration. The patient was treated with articular branch ligation and has had complete resolution of his symptoms without recurrence of the cyst on follow-up imaging. LESSONS This case adds to the mounting evidence that intraneural cyst pathology is dependent on a connection to a synovial joint as stated in the unifying theory of intraneural cyst development.

Intraneural Ganglion cyst of The Deep Peroneal Nerve Causing Rapidly Progressive Foot Drop

Intraneural ganglion cysts are a relatively uncommon cause of peroneal nerve palsy. Patient’s typically present with weakness or absent ankle dorsiflexion, knee or leg pain, and paresethesia. Surgical decompression is widely accepted as the first line treatment for intraneural ganglion cysts of the peroneal nerve, with earlier intervention associated with better functional outcomes. Here, we describe the case of a 57-year-old male found to have a intraneural ganglion cyst of the peroneal nerve, three months after the onset of symptoms, including eventual complete foot drop. He underwent surgical decompression of the cyst. The intraneural ganglion cyst was found to be intricately involved with the nerve fibers, and the patient still does not have the ability to dorsiflex the affected ankle one month post-operation.