Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve

Jae Young Kim; Hye Kyung Lee; Jaeho Cho

doi:10.14193/jkfas.2014.18.1.36

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Kim, Lee, and Cho: Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve

Case Report

J Korean Foot Ankle Soc 2014;18(1):36-39.

Published online: 10 March 2014

DOI: https://doi.org/10.14193/jkfas.2014.18.1.36

Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve

Jae Young Kim, Hye Kyung Lee^*, Jaeho Cho

Department of Orthopedic Surgery, Seoul, Korea

^*Department of Pathology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

Corresponding Author: Jaeho Cho Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea Tel: 82-2-2270-0042, Fax: 82-2-2270-0023, E-mail: hohotoy@nate.com

Received 6 January 2014 Revised 14 January 2014 Accepted 27 January 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tarsal tunnel syndrome is defined as a compressive neuropathy of the posterior tibial nerve in the tarsal canal. 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. In addition, local recurrence occurs less than 5%. We report on a case of tarsal tunnel syndrome caused by a large recurred space-occupying lesion measuring 4.3×2.7×2.7 cm³.

Keywords: Tarsal tunnel syndrome, Schwannoma, Neurilemmoma, Recurrence

References

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Figure 1.

The sagittal (A) and coronal (B) sonogram shows an oval shaped well-defined hypoechoic mass with inhomogeneous echo texture. (C) Color-coded Doppler scan shows flow signals in the mass.

Figure 2.

Sagittal T2-weighted magnetic resonance imaging image with high signal intensity on the total mass without target sign.

Figure 3.

Intraoperative finding of mass arising from posterior tibial nerve.

Figure 4.

A well circumscribed, encapsulated, multilobulated, solid mass revealed diffusely myxoid and homogenously grayish yellow cut surfaces.

Figure 5.

(A) Histological features exhibit neurogenic, spindle cell proliferation with biphasic pattern of growth and prominent nuclear palisading (H&E stain, ×100). (B) Spindle tumor cells express diffuse strong immunoreactivity for S-100 protein (×200).

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