Intraneural ganglion: a case report with electron microscopic observations

Area of Science:

• Neurology
• Orthopedic Surgery
• Pathology

Background:

• Intraneural ganglia are rare cystic masses originating within nerve fascicles.
• Common peroneal mononeuropathy presents with motor, sensory, and pain symptoms, often impacting mobility.
• Understanding the etiology of peripheral nerve compression is crucial for effective treatment.

Observation:

• A 9-year-old boy presented with common peroneal mononeuropathy attributed to an intraneural ganglion.
• Surgical excision under microscopy revealed cyst wall composed of myofibroblasts, consistent with joint-derived ganglia.
• Histological examination showed nerve fascicle changes indicative of pressure-ischemia.

Findings:

• The case highlights intraneural ganglion as a cause of common peroneal nerve dysfunction.
• Literature review identified 44 additional cases, with 86% affecting the common peroneal nerve.
• Motor dysfunction was the predominant clinical feature, followed by pain, sensory loss, and palpable mass.

Implications:

• This study contributes to the understanding of intraneural ganglion pathogenesis and its impact on peripheral nerves.
• Accurate diagnosis and surgical intervention are key for managing this condition.
• Further research into the cellular mechanisms and predisposing factors may improve patient outcomes.