Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13373-13380
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13373
Recurrence of intratendinous ganglion due to incomplete excision of satellite lesion in the extensor digitorum brevis tendon: A case report
Jeong Jin Park, Hyun Gyu Seok, Hongfei Yan, Chul Hyun Park
Jeong Jin Park, Hyun Gyu Seok, Hongfei Yan, Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea, Daegu 42415, South Korea
Chul Hyun Park, Department of Orthopaedic Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea
Author contributions: Park JJ and Park CH contributed to manuscript writing and editing, and data collection; Park JJ, Seok HG, and Yan HF contributed to data analysis; Park CH contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chul Hyun Park, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Orthopaedic Surgery, College of Medicine, Yeungnam University, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. chpark77@naver.com
Received: August 12, 2022
Peer-review started: August 12, 2022
First decision: October 12, 2022
Revised: October 27, 2022
Accepted: December 9, 2022
Article in press: December 9, 2022
Published online: December 26, 2022
Abstract
BACKGROUND

Intratendious ganglions are rare lesions, especially on the foot and ankle. Although several studies have presented the intratendinous ganglion of the foot and ankle, there are only few reported cases, and no cases of recurrence or secondary surgery have been reported.

CASE SUMMARY

We present the case of a 32-year-old man with an intratendinous ganglion of the second extensor digitorum brevis (EDB) tendon that recurred after ganglion excision. Magnetic resonance imaging (MRI) performed before the first surgery was reviewed to analyze the causes of the recurrence. We confirmed that there was a lack of satellite detection. After recurrence, MRI revealed an extra-tendinous lesion, tenosynovitis, and intratendinous ganglion of the second EDB tendon. Since the second EDB tendon can compensate for the extrinsic muscle, en bloc resection was performed alone. In addition, meticulous excision and synovectomy were performed for extra-tendinous lesions and tenosynovitis, respectively. The patient returned to daily life without any functional problems or recurrence.

CONCLUSION

If removal of the affected tendon is not fatal, en bloc resection should first be considered to prevent incomplete excision and intraoperative leakage. When planning surgical excision, it is necessary to evaluate the presence of satellite lesions along the course of the affected tendon.

Keywords: Intratendinous ganglion, Recurrence, Surgical excision, En bloc resection, Case report

Core Tip: Intratendinous ganglion is rare, especially foot and ankle lesions. Surgical treatment should be considered for patients with persistent pain, nerve compression, tendon dysfunction, or recurrence after conservative treatments. Surgical methods include excision of the ganglion and en bloc resection. Surgical excision of the ganglion has the advantage of preserving tendon function, but the risk of recurrence due to incomplete excision is high. In addition, failure of complete excision can lead to more severe clinical features with extra-tendinous lesions and tenosynovitis. Therefore, if loss of function of the affected tendon does not cause significant functional impairment, en bloc resection may be considered first.