Ganglion Cysts and Other Masses of the Hand and Wrist
Masses or lumps can sometimes develop on the hand or wrist. The most common of these is a ganglion cyst: a fluid-filled lump that may form along the tendons or joints of the hand or wrist. Ganglion cysts and other masses of the hand and wrist are usually benign, and often they do not even need treatment. But if they do become bothersome or symptomatic, treatment can eliminate the mass and provide relief.
Common masses of the hand and wrist include:
- Ganglion Cysts: A ganglion cyst is a fluid-filled lump that most commonly forms along the tendons or joints of the hand or wrist. They are typically round or oval in shape and can vary in size, growing or shrinking from time to time. Some may persist while others disappear on their own. Sometimes, a ganglion cyst may affect joint movement or press on a nearby nerve, causing pain and/or numbness. If treatment is desired, a ganglion cyst can be aspirated or surgically removed.
- Giant Cell Tumor of the Tendon Sheath: Despite its name, this common mass is not cancerous. Unlike ganglion cysts, giant cell tumors are solid rather than filled with liquid. They may also slowly grow larger over time, sometimes causing symptoms such as pain or discomfort. If treatment is desired, a giant cell tumor may be surgically excised.
- Epidermal Inclusion Cyst: An epidermal inclusion cyst is another benign mass that can form underneath the skin where there has been a cut or puncture. As skin cysts, most are filled with keratin. Most will not go away on their own without treatment, but some may shrink in size and remain asymptomatic. Epidermal inclusion cysts are not usually painful, but if they rupture, they may cause pain, inflammation, and swelling. Treatment for these is usually surgical excision.
- Other Masses: Other masses of the hand and wrist are less common, but nearly all are benign. Examples include fatty lipomas, fibromas, neuromas, and others.
Frequently Asked Questions
Many hand masses are diagnosed with a simple hand examination. Sometimes an X-ray and/or ultrasound, CT, or MRI scan may be done. Occasionally, a biopsy may be considered to confirm the diagnosis before recommending an appropriate treatment.
Most masses of the hand or wrist have no known cause. No one knows what causes ganglion cysts, but they are more common in people with osteoarthritis or joint or tendon injury. Giant cell tumors of the tendon sheath may be associated with degenerative joint disease. Epidermal inclusion cysts may form due to an injury of the skin.
Many ganglion cysts do not need treatment; they may not cause any symptoms, and some will even go away on their own. But if you are bothered by the appearance of your ganglion cyst, or if it is causing symptoms such as pain, numbness, or limited movement, we can aspirate or surgically excise the ganglion cyst for you.
If you need treatment for a ganglion cyst, either aspiration or surgery can be performed to get rid of the mass. Aspiration is the less-invasive option, but it has a higher rate of cyst recurrence because it only drains the fluid and leaves the cyst stalk attached to the tendon or joint. Surgery to excise a ganglion cyst removes both the cyst and its stalk, giving it a lower rate of recurrence. Unfortunately, ganglion cysts may still return even after surgery. But while recurrence is always a risk, it is still worth pursuing treatment because it can provide the relief you seek.