Neurilemoma of the popliteal fossa :
Report of two cases with long subclinical course and misleading presentation
Published online: Aug 27 2005
Theodoros MARAZIOTIS, Elias PANAGIOTOPOULOS, Vasilios PANAGIOTOPOULOS, Konstantinos PANAGIOTOPOULOS
From University Hospital of Patras, Greece
Abstract
The authors report two cases of neurilemoma
localised in the popliteal fossa. Both patients experienced
non-specific symptoms, such as painful
numbness and burning dysaesthesia, involving the
lower extremity. Tinel's sign was positive over the
popliteal fossa. The patients sought medical advice
and underwent conservative treatment without any
relief, for a long time before the right diagnosis was
made. Magnetic Resonance Imaging revealed in both
patients a well- circumscribed mass posterior to the
sciatic nerve, occupying the popliteal fossa. Following
surgical excision of the neurilemoma, the patients
experienced immediate relief of their chronic symptoms.
In similar situations, ultrasound or magnetic
resonance imaging of the whole sciatic nerve should
be performed if this is indicated by detailed physical
examination. Once the diagnosis is made, neurilemomas
should be surgically removed, in order to
exclude malignancy, prevent neurologic deficits and
provide relief of symptoms.