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Case of the Month

June 2011

Patient Data: Female 52 years old

Clinical Info: Palpable mass and peroneal nerve neuropathy

Longitudinal image of the peroneal nerve next to the fibular head. The proximal part of the nerve shows a normal fascicular pattern. The distal part shows an abnormal widening and structure

Another longitudinal image of the peroneal nerve with a normal proximal and abnormal distal part

Longitudinal image of the distal part showing a lipomatous structure

Longitudinal combined image of the lipomatous structure in relation to the peroneal nerve

Another longitudinal image showing the relation of the lipomatous structure and the peroneal nerve

Transverse image of the lipomatous structure

MRI image showing the peroneal nerve

MRI image showing the lipoma

This long lesion in a 19 year old female also has a relation with the peroneal nerve (arrow). In this case the lesion is cystic and represents a neural ganglion cyst that arises in the tibiofibular joint and extends cranialy along the peroneal nerve

The first lesion proved to be a perineural fibrolipoma of the peroneal nerve. The patient was not operated because she had minor symptoms and because of the risk of nerve injury.
The second patient with the neural ganglion cyst was operated but had loss of peroneal function post surgically. The function returned after a few months. Another case of a neural ganglion cyst is presented as case of the month January 2006
In case of a lipoma or a ganglion cyst always check if there is continuity with a nerve

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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