Periosteal ganglion of the tibia

Periosteal ganglion cyst of tibia: A rare case report

INTRODUCTION AND IMPORTANCE

Periosteal ganglion cyst is a rare disorder, found only in 55 out of 100,000 people annually. Periosteal ganglion location may cause partial external cortical destruction with irregular saucerization and erosion. This report presents a rare case of periosteal ganglion cyst that occurred of the cruris sinistra.

CASE PRESENTATION

A male patient, 68 years old, came with complaint of a lump in the left cruris since one year ago. Nine months later, the lump has increased in size like a chicken egg and still felt painless. MRI result revealed a well-circumscribed multilocular cystic lesion in the peri-osseous soft tissue of the tibia. We performed directly excisional biopsy within the mass, and the histopathology result was periosteal ganglion cyst.

CLINICAL DISCUSSION

The exact pathogenesis of periosteal ganglion is unclear. Synovial herniation and mucoid degeneration of the connective tissue of the periosteum are two suggested mechanisms. In some cases, ganglion cysts may compress nearby nerves. Surgical treatment is recommended for patients who still experience symptoms after non-surgical management has failed. Complete resection of the cyst and surrounding periosteum is recommended to prevent recurrence. After 6 months post-operative follow up clinical examination, no recurrence symptoms founded on the patient.

CONCLUSION

Periosteal ganglion is a rare lesion and may mimic other bone surface lesions. Resection of the periosteal ganglion cyst with surrounding periosteum is important to prevent recurrence.

A case report on rare occurrence of periosteal ganglion cyst in femoral intercondylar region

Ganglions are the cysts derived from myxomatous degeneration of periarticular tissue, commonly found around wrist and foot. Ganglion cysts are uncommon in Knee region and if present their occurrence is mostly incidental and benign. Based on their location, this could be extraarticular or intraarticular. Lesions with similar pathology in subchondral region around joints are lesser common entity called Intraosseous ganglions. Rarer still is the lesion produced by myxomatous degeneration of periosteum of long bone, called periosteal ganglion. We here present a case of 35 year old Male with gradual onset, poorly localised pain behind left knee which was radiologically suggestive of periosteal ganglion, eroding the posterior aspect of femur and confirmed histopathologically following the excision of a lesion from posterior aspect of femoral condyles.

Tibial periosteal ganglion cyst: The ganglion in disguise

Soft tissue ganglions are commonly encountered cystic lesions around the wrist presumed to arise from myxomatous degeneration of periarticular connective tissue. Lesions with similar pathology in subchondral location close to joints, and often simulating a geode, is the less common entity called intraosseous ganglion. Rarer still is a lesion produced by mucoid degeneration and cyst formation of the periostium of long bones, rightly called the periosteal ganglion. They are mostly found in the lower extremities at the region of pes anserinus, typically limited to the periosteum and outer cortex without any intramedullary component. We report the case of a 62 year-old male who presented with a tender swelling on the mid shaft of the left tibia, which radiologically suggested a juxtacortical lesion extending to the soft tissue or a soft tissue neoplasm eroding the bony cortex of tibia. It was later diagnosed definitively as a periosteal ganglion in an atypical location, on further radiologic work-up and histopathological correlation.

Periosteal ganglion in a child

A case of periosteal ganglion in a 10-year-old boy is reported. The diagnosis of periosteal ganglion was made on roentgenographic and MR appearance and histologic evidence. The patient was successfully treated by excision. The follow-up examination showed no recurrence. Periosteal ganglia must be considered a cause of expanding cortical erosions. This lesion may mimic other peripheral expanding lesions.

Periosteal ganglion of the radius: a case report

We report a case of 43-year-old female with a periosteal ganglion arising in the right radius. Plain radiographs showed thick and sparse spicula with shallow and irregular cortical erosion, which suggested periosteal ganglion. Magnetic resonance (MR) imaging revealed a well circumscribed homogeneous lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. No apparent enhancement observed after gadolinium injection suggested that the lesion was cystic. At operation, gelatinous material was removed together with the spicula, the surface of the cortex and the overlying periosteum. There was no clinical evidence of recurrence after three years of surgical treatment. MR imaging was thought to be useful to confirm the diagnosis of periosteal ganglion.