Korean J Sports Med.  2019 Mar;37(1):29-31. 10.5763/kjsm.2019.37.1.29.

Cubital Tunnel Syndrome by a Ganglion Cyst in an Amateur Tennis Player

• Bang JY

• KMID: 2440634
• DOI: http://doi.org/10.5763/kjsm.2019.37.1.29

Abstract

Ganglion cyst is considered to be a usual cause of peripheral nerve compression. In this report, we present a rare case of ulnar nerve compression by a multi-septated ganglion cyst in the cubital tunnel. A 33-year-old left-handed male amateur tennis player developed progressive numbness and weakness in his right elbow, forearm, and hand for 1 year. Decrease of grip power was apparent in left hand. Clinical examination revealed a cystic mass at the posterior side of the elbow. Magnetic resonance imaging identified a ganglion cyst at the elbow. During surgery about 3 cm diameter epineural ganglion was observed compressing the ulnar nerve and was excised using microsurgery techniques. Three months postoperatively, the clinical recovery of the patient was very satisfactory and he restored his original performance in tennis match.

Keyword

Cubital tunnel syndrome; Ganglion cysts; Ulnar nerve

MeSH Terms

Adult
Cubital Tunnel Syndrome*
Elbow
Forearm
Ganglion Cysts*
Hand
Hand Strength
Humans
Hypesthesia
Magnetic Resonance Imaging
Male
Microsurgery
Peripheral Nerves
Tennis*
Ulnar Nerve
Ulnar Nerve Compression Syndromes

Figure

• 

  Fig. 1 Plan radiographs (A: anteroposterior, B: lateral view) show no specific osteoarthritic change.

• 

  Fig. 2 Preoperative T2 axial (A) and coronary (B) magnetic resonance images show multi-septated ganglion cyst with hyperintense signal in cubital tunnel syndrome. Coronary T1 magnetic resonance image (C) shows hypointense signal of ganglion cyst.

• 

  Fig. 3 Intraoperative photograph shows ganglion cyst compressing ulnar nerve at the level of cubital tunnel.

Reference

1. Andrews K, Rowland A, Pranjal A, Ebraheim N. Cubital tunnel syndrome: anatomy, clinical presentation, and management. J Orthop. 2018; 15:832–836.

2. Tong J, Xu B, Dong Z, Liu J, Zhang C, Gu Y. Cubital tunnel syndrome caused by ganglion cysts: a review of 59 cases. Acta Neurochir (Wien). 2017; 159:1265–1271.

3. Kojima T, Kurihara K, Nagano T. A study on operative findings and pathogenic factors in ulnar neuropathy at the elbow. Handchirurgie. 1979; 11:99–104.

4. Sharma RR, Pawar SJ, Delmendo A, Mahapatra AK. Symptomatic epineural ganglion cyst of the ulnar nerve in the cubital tunnel: a case report and brief review of the literature. J Clin Neurosci. 2000; 7:542–543.

5. Sim GB, Kim CW, Sun JH, Kim JS, Chun JM, Jeon IH. Cubital tunnel syndrome. J Korean Orthop Assoc. 2014; 49:346–354.

6. Harbaugh KS, Tiel RL, Kline DG. Ganglion cyst involvement of peripheral nerves. J Neurosurg. 1997; 87:403–408.

7. Kato H, Hirayama T, Minami A, Iwasaki N, Hirachi K. Cubital tunnel syndrome associated with medial elbow Ganglia and osteoarthritis of the elbow. J Bone Joint Surg Am. 2002; 84:1413–1419.

8. Treihaft MM. Neurologic injuries in baseball players. Semin Neurol. 2000; 20:187–193.