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Posterior tibial nerve sheath tumor

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

A mass sensation at the posterior aspect of the left ankle joint for six years. Clinically the mass was firm and painful during direct palpation.

Patient Data

Age: 30 years
Gender: Male

There is a 25x30 mm well-defined ovoid heterogeneous solid lesion on the posterior aspect of the ankle joint. The lesion seems to be associated with the posterior tibial neurovascular bundle and is located lateral to the posterior tibial vessels. It abuts and creates a mass effect on the flexor hallucis longus musculotendinous junction.

Case Discussion

With regard to the clinical and MRI imaging findings, the tibial nerve sheath tumor was the most probable diagnosis. The patient refused to have surgery and resection of the mass for confirmation of diagnosis.

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