Plexiform Neurofibroma of the Posterior Tibial Nerve Misdiagnosed as Proximal Tarsal Tunnel Syndrome: A Case Report

Abstract

Plexiform neurofibromas of the foot are rare, benign tumors of the peripheral nerves. Diagnosis can be challenging if they present with symptoms mimicking other peripheral nerve pathologies. Tarsal tunnel syndrome is an entrapment syndrome of the entire tibial nerve behind the medial malleolus and under the flexor retinaculum. The clinical presentation typically includes posteromedial pain, positive Tinel's sign, and neurogenic signs, including both the sensation of numbness and the actual hypoesthesia and clawing of the toes.

Here, we report the case of a 59-year-old female patient with plexiform neurofibroma with symptoms similar to those of tarsal tunnel syndrome. The plexiform neurofibroma was surgically excised and the nerve function was partially preserved.

Keywords

neurofibroma - tarsal tunnel syndrome - Tinel's sign

Publikationsverlauf

Eingereicht: 23. Oktober 2017

Angenommen: 12. Januar 2018

Publikationsdatum:
28. Februar 2018 (online)

• References

• 1 Guclu E, Tokmak A, Oghan F, Ozturk O, Egeli E. Hemimacroglossia caused by isolated plexiform neurofibroma: a case report. Laryngoscope 2006; 116 (01) 151-153
• 2 D'Orazi V, Venditto T, Panunzi A. , et al. Misdiagnosis of plexiform neurofibroma of the medial plantar nerve: case report. Foot 2014; 24 (03) 143-145
• 3 Pu LL, Vasconez HC. Large recurrent plexiform neurofibroma of the foot and ankle. Microsurgery 2004; 24 (01) 67-71
• 4 Ferner RE, Huson SM, Thomas N. , et al. Guidelines for the diagnosis and management of individuals with neurofibromatosis 1. J Med Genet 2007; 44 (02) 81-88
• 5 Gould JS. Recurrent tarsal tunnel syndrome. Foot Ankle Clin 2014; 19 (03) 451-467
• 6 McSweeney SC, Cichero M. Tarsal tunnel syndrome-a narrative literature review. Foot 2015; 25 (04) 244-250
• 7 DeFazio MV, Ter Louw RP, Attinger CE, Barbour JR. Management of advanced plexiform neurofibromatosis of the foot presenting with skeletal deformation and intractable pain: an indication for proximal amputation. Foot 2015; 25 (01) 30-35
• 8 Bourne JT, Mangaleshkar SR, Meis-Kindblom JM, Bradish C. Recurrent plexiform neurofibromatosis of the foot with extensive bone destruction. J Pediatr Orthop B 2009; 18 (04) 176-178
• 9 Sweed TA, Ali SA, Choudhary S. Tarsal tunnel syndrome secondary to an unreported ossicle of the talus: a case report. J Foot Ankle Surg 2016; 55 (01) 173-175
• 10 Woodruff JM. Pathology of tumors of the peripheral nerve sheath in type 1 neurofibromatosis. Am J Med Genet 1999; 89 (01) 23-30
• 11 Freitas D, Aido R, Sousa M, Costa L, Oliveira V, Cardoso P. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach. BMJ Case Rep 2013; 2013 , pii: bcr2012008194
• 12 Korf BR. Plexiform neurofibromas. Am J Med Genet 1999; 89 (01) 31-37
• 13 Tchernev G, Chokoeva AA, Patterson JW, Bakardzhiev I, Wollina U, Tana C. Plexiform neurofibroma. Medicine (Baltimore) 2016; 95 (06) e2663