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Il Giornale Italiano di Radiologia Medica 2018 Settembre-Ottobre;5(5):655-9

DOI: 10.23736/S2283-8376.18.00113-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Imaging of an unusual case of a sural intraneural ganglion cyst

Michele FORESTI

Dipartimento Diagnostica per Immagini e Medicina di Laboratorio Azienda USL-IRCC, UOS Radiologia Ospedale C. Magati Scandiano, Reggio Emilia, Italia


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Intraneural ganglion cysts are benign mucinous lesions that are formed within peripheral nerves and typically lead to symptoms and signs of peripheral neuropathy. Their pathogenesis has been controversial and different treatments have been recommended. Outcomes have been disappointing and the recurrence rate high. In 2003 it has been demonstrated that the prototypical intraneural cysts of the common peroneal nerve are joint derived. Since then this theory called Unifying Articular (Synovial) Origin of the intraneural ganglion cysts, has been further substantiated for many other nerves and several other anatomical locations. One of these relatively unusual localizations is the sural nerve about which some intraneural ganglion cyst development case reports have been reported since now; often a connection between the ganglion and the subtalar or calcaneo-cuboid joints by articular neural branches have been described. We present a case report about a man just known to be affected by the Charcot Marie Tooth syndrome, who reports the development of a subcutaneous longitudinal swelling in the medium-distal posterior region of the leg and who comes to our attention for the execution of an MRI exam. The MRI sequences demonstrate the presence of a pluriloculated longitudinal cystic lesion within the sural nerve compatible with a intraneural ganglion cyst with demonstration of a thin posterior subtalar connection. Therefore, also in our case report these findings correlate with the unifying articular origins of the intraneural ganglion cysts and with the more recent available literature.


KEY WORDS: Ganglion cyst - Peripheral nerves - Ultrasonography - Magnetic resonance imaging

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