RESUMO
Intraneural lipomas, neurofibrolipomas, lipofibromatous hamartomas, and perineural lipomas are subsets of hamartomas that typically present as fibroadipose, soft tissue masses within the epineurium of a nerve. Several cases involving intraneural lipomas of the median nerve in the upper extremity have been reported; however, owing to the lesion's rare incidence in the foot and ankle, only a select few cases involving the superficial peroneal nerve have been reported. We present the first case of a tibial nerve intraneural lipoma in a 42-year-old female with a follow-up period of 2 years. We discuss the clinical presentation, distinguishing features, surgical procedures, and short-term outcome regarding this unique tumor.
Assuntos
Lipoma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Tibial/cirurgia , Articulação do Tornozelo/patologia , Articulação do Tornozelo/cirurgia , Biópsia por Agulha , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Lipoma/diagnóstico por imagem , Lipoma/patologia , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Medição da Dor , Posicionamento do Paciente , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/patologia , Doenças Raras , Nervo Tibial/diagnóstico por imagem , Nervo Tibial/patologia , Resultado do TratamentoRESUMO
Traumatic degloving injuries of the lower extremity are commonly diagnosed by soft tissue deficits and separation of soft tissue planes. The management of open degloving injuries is well documented with established treatment protocols. Because closed degloving injuries of the lower extremity are so rare, the protocol management is not well established. Unlike open degloving injuries, evidence of soft tissue injury and detachment of the tissue planes can be subtle. Owing to the rarity of these injuries, little has been described regarding the long-term outcomes. In the present report, 2 closed degloving cases are presented. The first case presented is of a 27-year-old railroad worker who sustained a severe closed degloving injury of his foot with digital soft tissue envelope transposition. The second case involved a 60-year-old automobile manufacturer, whose foot was crushed by a hydraulic fork lift, creating a degloving injury of the third, fourth, and fifth toes. The follow-up duration from the date of injury for patient 1 was 26 months and for patients 2 was 16 months. The purpose of presenting these cases is to report these rare injuries with the treatment, complications, and outcomes.
