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Revista Archivo Médico de Camagüey

On-line version ISSN 1025-0255


HERNANDEZ GONZALEZ, Erick Héctor; PEREZ SOSA, Guillermo  and  MOSQUERA BETANCOURT, Gretel. Syndrome of the tarsal tunnel caused by an epineural ganglion. AMC [online]. 2013, vol.17, n.6, pp.121-128. ISSN 1025-0255.

Background: the syndrome of the tarsal tunnel is a neuropathy caused by trapping the posterior tibial nerve and its branches in the flexor retinaculum. The diagnosis can be difficult and the surgical treatment is indicated for most of the patients. Objective: to present a case of syndrome of the tarsal tunnel caused by an epineural ganglion and to familiarize the medical staff with this infrequent cause of pain and paresthesia in the foot. Clinical Case: a fifty-one-year-old female patient comes to the consultation because of a rise in volume and pain in the posteroinferior area of the left tibial malleolus, associate to paresthesia radiated to the plantar region. In the physical examination, a three-cm fluctuating single tumor that was fixed to deep planes and painful on percussion was confirmed. The ultrasonography of soft parts showed an image of cystic aspect of 26 x 14.8 mm with well-defined margins and fine walls, partitioned and closely related to the posterior tibial nerve. The initial treatment was conservative but the patient did not get better; that is why a definitive surgical treatment that consisted in the exeresis of the cystic lesion was chosen with the objective of reducing pain and paresthesia. Conclusion: the syndrome of the tarsal tunnel caused by an epineural ganglion is considered an infrequent diagnosis; that is why any lesion of a cystic consistency that occupies the tarsal tunnel can make think on the diagnosis. The surgical treatment is safe and effective solving the clinical manifestations with a minimal of complications


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