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Case Reports
. 2017 Oct 4:2017:bcr2017220704.
doi: 10.1136/bcr-2017-220704.

Management and patients perspective regarding a common peroneal nerve schwannoma: a rare cause of lower leg pain in a young individual

Aniek Pm van Zantvoort  1 , Paul Cuppen  2 , Marc R Scheltinga  1
Affiliations
Case Reports

Management and patients perspective regarding a common peroneal nerve schwannoma: a rare cause of lower leg pain in a young individual

Aniek Pm van Zantvoort et al. BMJ Case Rep. .

Abstract

The differential diagnosis of exercise-induced lower leg pain in young individuals is extensive and includes entities such as chronic exertional compartment syndrome, popliteal arterial entrapment syndrome, cystic adventitial disease, medial tibial stress syndrome and tibial stress fractures. Peripheral nerve-related lower leg pain syndromes are unusual. We present a 41-year-old woman who was diagnosed with an ancient schwannoma of the right common peroneal nerve (CPN) as a rare cause of lower leg pain. This case report provides simple diagnostic bedside tools that may be used to diagnose CPN abnormalities. Altered lateral lower leg skin sensation was found using a simple cotton swab, whereas a nodule was palpated at the fibular head. A positive Tinel sign indicated CPN dysfunction. MRI confirmed the diagnosis. Surgical resection is simple and curative.

Keywords: Surgery, sports and exercise medicine; neurology; pain; peripheral nerve disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Ultrasound of the common peroneal nerve (blue arrow) demonstrating a 1.3 cm×0.74 cm echodense swelling behind the fibular head (red arrow).
Figure 2
Figure 2
Transversal T2-weighted MRI slide of both lower legs. The right leg shows a lesion of the common peroneal nerve at the level of the fibular head suggesting a schwannoma.
Figure 3
Figure 3
Lateral aspect of right lower leg. (A) The overlying fascia is incised. (B) After incision of the nerve’s perineurium, a 2×1 cm swelling was removed.
See this image and copyright information in PMC

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