The patient came to the clinic 21-September-2014 complaining of left ankle pain for 4 years with feeling of a mass in the tarsal area  for 4 months. MRI of the left ankle done 08-September-2014 showing a mass in the left tarsal region suggesting schwannoma.

On examination; there is slight swelling of the left tarsal area with no palpable mass. Inspection of the area is very painful. Tinel's test positive. Durkan's compression test could not be performed due to severe pain. All ankle movements produced pain. Neurologically the patient is free.

MRI of the lumbar spine done 23-September-2014 almost normal. The patient performed several times EMG and ECS confirming the presence of tarsal tunnel syndrome.

Incision over the trajectory of the left posterior tibial nerve. The nerve was identified and the calceneal branch and the lateral and medial planter nerves were identified. There was no mass at the tarsal tunnel level and the Inomed ISIS was used and the nerve is functioning well. The posterior tibial artery was also preserved. The wound was extended upward and the nerve was followed to the level of the medial calcaneal nerve emergence. At that level there was a mass compressing the posterior tibial nerve, and pushing the branches of the medial calcaneal nerve. The tumor was resected totally and sent for biopsy. Routine closure of the wound.

Smooth postoperative recovery.

The patient has a mass above the retinaculum flexorum. In this situation the mass was resected and the tarsal tunnel release was done.