Intraneural ganglion cysts are benign soft-tissue masses located in the epineurium of peripheral nerves. They originate from nearby\njoint connections via articular branches. Traumatic events seem to play a role in their pathogenesis as well. Clinical manifestations\ninclude pain over the area of the cyst, palpable tender mass, hypoesthesia, and muscle weakness depending on the affected nerve.\nOur case highlights an uncommon clinical manifestation of this entity with acute foot drop, as the primary symptom, without any\nprevious traumatic event, enriching by this way the current diagnostic thinking process of clinical physicians. We report a case of a\n42-year-old military officer who presented to our emergency department with acute foot drop that appeared during a march.\nInitially, the common peroneal palsy was misdiagnosed as L5-S1 disc herniation, but investigation with lumbar MRI scan led to\nrejection of our primary diagnosis. After performing EMG of the lower extremity and knee MRI, an intraneural ganglion cyst of\nthe common peroneal nerve was diagnosed. Patient was treated with surgical decompression of the cyst, followed by ligation\nand complete resection of the articular branch, as well as disarticulation of the superior tibiofibular joint. At a twelve-month\nfollow-up, the patient showed significant functional recovery. This is, to the best of our knowledge, the first case of intraneural\nganglion cyst manifested with an acute complete foot drop without a clear prior traumatic event. We underline the need for a\nhigh index of suspicion when dealing with cases of acute peroneal palsy without any accompanying symptoms
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