CYSTIC NEUROMA OF THE POSTERIOR TIBIAL NERVE.
By J.
Physician, Neuromata his attention an
Bristol
were
being
uncommon
Fenton
Evans, M.B., House
Royal Infirmary.
first described
directed to the
by Cheselden in 1740, cystic variety, although
form.
According to Paget there are four forms of (excluding from consideration the somewhat tumour of nerves, where the
true
nerve
neuroma
doubtful
elements
are
hypertrophied), i.e., cystic, fibrous, fibro-cystic and cancerous, the latter occurring least frequently, and stated by originate in nerve trunks, but to invade them from neighbouring structures, the true neuroma being never malignant." some
writers
never to
"
CYSTIC NEUROMA.
110
Neuromata may be idiopathic or traumatic, single or multiple, when traumatic as a rule single. They are
commonly sympathetic. more
found
To the traumatic class on
but
as
the fibrous
than
on
enlargements
nerves
distance from the tumours
belong
nerves
in stumps, often the source of sufferfrequently painless, and occurring at some
the ends of
ing,
cerebro-spinal
on
cicatrix;
cases
are
also recorded of
arising in the course of an individual nerve as injury, and producing great pain both above
the result of
and below the seat of the with the
?the distribution of the
new
fibrous
tumour the
single idiopathic
nerve on
whereas
is confined to
which it exists.
The
idiopathic neuromata may single generally very painful,
when
growth,
pain
be
single
when
or
multiple;
numerous
often
undiscovered before death. I
was
fortunate
enough
to meet with
the
a
specimen
tibial
of
of
a multiple cystic posterior in our dissecting room last winter. subject On removing the gastrocnemius and soleus muscles with the deep fascia a chain of blueish glistening bodies was to be seen running continuously in the course of the posterior tibial nerve, lobulated and varying in size from a pea to a hazel nut, commencing above in the popliteal space and ending below at the ankle joint, with which the lowest cysts appeared to communicate (PI. V.). The nerve increased in size, split up into several bands, some entering the growth at the upper end and some at various points in its course, one trunk running neuroma on
down to the foot
independently.
On section the cavities have
other,
and contain
Under the
nerve
a
no
connection with each
clear albuminous
microscope
jelly.
the cyst wall is
seen to
consist
Plate V.
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By J.
Physician, Neuromata his attention an
Bristol
were
being
uncommon
Fenton
Evans, M.B., House
Royal Infirmary.
first described
directed to the
by Cheselden in 1740, cystic variety, although
form.
According to Paget there are four forms of (excluding from consideration the somewhat tumour of nerves, where the
true
nerve
neuroma
doubtful
elements
are
hypertrophied), i.e., cystic, fibrous, fibro-cystic and cancerous, the latter occurring least frequently, and stated by originate in nerve trunks, but to invade them from neighbouring structures, the true neuroma being never malignant." some
writers
never to
"
CYSTIC NEUROMA.
110
Neuromata may be idiopathic or traumatic, single or multiple, when traumatic as a rule single. They are
commonly sympathetic. more
found
To the traumatic class on
but
as
the fibrous
than
on
enlargements
nerves
distance from the tumours
belong
nerves
in stumps, often the source of sufferfrequently painless, and occurring at some
the ends of
ing,
cerebro-spinal
on
cicatrix;
cases
are
also recorded of
arising in the course of an individual nerve as injury, and producing great pain both above
the result of
and below the seat of the with the
?the distribution of the
new
fibrous
tumour the
single idiopathic
nerve on
whereas
is confined to
which it exists.
The
idiopathic neuromata may single generally very painful,
when
growth,
pain
be
single
when
or
multiple;
numerous
often
undiscovered before death. I
was
fortunate
enough
to meet with
the
a
specimen
tibial
of
of
a multiple cystic posterior in our dissecting room last winter. subject On removing the gastrocnemius and soleus muscles with the deep fascia a chain of blueish glistening bodies was to be seen running continuously in the course of the posterior tibial nerve, lobulated and varying in size from a pea to a hazel nut, commencing above in the popliteal space and ending below at the ankle joint, with which the lowest cysts appeared to communicate (PI. V.). The nerve increased in size, split up into several bands, some entering the growth at the upper end and some at various points in its course, one trunk running neuroma on
down to the foot
independently.
On section the cavities have
other,
and contain
Under the
nerve
a
no
connection with each
clear albuminous
microscope
jelly.
the cyst wall is
seen to
consist
Plate V.
/* M?.' 0
f/Ju 'pi -'/': ^r M>S*r
i /
?S&sgisajsjlt
^
k S^N>.V
:??
"i
V
\ f/'
/ '//
;
'*'?
,7
?:?
Iff i
'"?i
;??
U
JSf.v>-??
