Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 57-year-old man with a painful tumoral mass in the leg.

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Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 57-year-old man with a painful tumoral mass in the leg

57-year-old man presented with a painful multinodular tumoral mass developing, over 7 months, in the lateral part of his right leg. MRI demonstrated a multinodular high intensity lesion in the sural nerve. Vignette Ogose et al. © 2014 American Academy of Neurology

A CB Ogose et al. Imaging A © 2014 American Academy of Neurology

A CB Ogose et al. Imaging A © 2014 American Academy of Neurology

The swollen sural nerve was surgically removed, and the tumor adhered to the subtalar joint. The surgical specimen revealed an intraneural ganglion cyst (Figure 1). Sixteen months after the surgery, the tumor recurred and was excised with the adhered subtalar joint capsule (Figure 2). The recurring cyst was not connected to the peripheral nerve. This case highlights the synovial (articular) origin of intraneural ganglion cysts. 1 Ogose et al. Recurrence of a sural intraneural ganglion cyst after sural nerve resection © 2014 American Academy of Neurology