PMC7476683_01
Pre-operative magnetic resonance imaging scan sagittal T2-weighted image (a), short-tau inversion recovery image (b), and axial images (c and d) showing cystic lesion.
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F1
The symptoms did not resolve, and subsequent magnetic resonance imaging (MRI) showed an elongated tubular, cystic-appearing mass near the fibular neck extending down till the middle third of the leg (Fig. 1).
Intraoperative image showing nerve exploration and ganglion cyst compressing the left peroneal nerve.
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F2
The fascia of the posterior compartment was incised, and the peroneal nerve was identified just beneath the cyst (Fig. 2).
Intraoperative image showing distal excision of the ganglion cyst up to its stalk.
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F3
The cyst was followed distally till its stalk and removed in toto (Fig. 3).
Intraoperative image showing the proximal dissection of the cyst up to its base from superior tibiofibular joint so as to decrease the chances of reoccurrence.
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F4
It was then explored for its proximal extension and removed, which measured 2.0 cmx2.0 cmx2.0 cm (Fig. 4, 5, 6).The peroneal nerve was inspected and found to be completely intact.
Intraoperative image showing the complete excision of the ganglion cyst and peroneal nerve decompression.
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F5
It was then explored for its proximal extension and removed, which measured 2.0 cmx2.0 cmx2.0 cm (Fig. 4, 5, 6).The peroneal nerve was inspected and found to be completely intact.
Gross image of the excised ganglion cyst which was sent for histopathological reporting.
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F6
It was then explored for its proximal extension and removed, which measured 2.0 cmx2.0 cmx2.0 cm (Fig. 4, 5, 6).The peroneal nerve was inspected and found to be completely intact.
Histopathological picture showing ganglion cyst with synovial cells lining (marked with arrows) under x10.
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F7
The specimen was sent for histopathology which confirmed the diagnosis of a ganglion cyst (Fig. 7).
Clinical image at 6-month follow-up showing complete recovery from foot drop and the patient was able to dorsiflex completely.
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F8
At 6-month follow-up, the patient reported full clinical recovery (Fig. 8), there were no signs of recurrence on ultrasonography (USG) even at 24-month follow-up.