A ganglion cyst is the most common cause of a mass or lump in the hand area. These cysts are generally filled with fluid and can occur in many body parts, but they are often seen at the back of the wrist. They are usually benign and non-cancerous.
These lumps arise from soft tissues like ligaments, tendons, or joint lining. They can vary in size and get bigger or smaller depending on activity.
Causes of Ganglion Cysts
The cause of ganglion cysts is not known. They tend to occur the most in people between 20-40. Women are slightly more likely to get these than men.
Signs and Symptoms of Ganglion Cysts
A ganglion cyst may present as a lump in the hand, wrist, or another joint. It is generally smooth, rounded, and firm. It may or may not be painful. The cyst may grow and shrink with time. If the mass is large or close to nerves, this may cause pain, tingling, numbness, and restriction of joint motion.
A thorough physical examination by a medical provider is generally sufficient to diagnose a ganglion cyst. Holding a small light against the mass will help the provider differentiate between a lump filled with fluid and one solid. Ganglion cysts glow when a light is held up to them, indicating fluid.
Ultrasound and MRI can help better understand where the mass is coming from and if it is invading other structures like nerves or arteries. These studies may also be helpful for pre-operative planning.
Treatment for Ganglion Cysts
This is an excellent option for asymptomatic patients who do not want any intervention done. More than half of patients will experience improvement or complete cyst resolution without invasive procedures. Resting the affected extremity may help to reduce the size of the mass.
Using a needle to draw out the fluid from the cyst may be helpful in patients who have bothersome symptoms. If the cyst is on the wrist’s or palm’s underside, aspiration must be done carefully to avoid critical structures like nerves and vessels. It is important to note that patients who have ganglion cysts treated this way may have a return of symptoms.
Surgical cyst removal is indicated in patients who have had symptoms for an extended period or those who have failed conservative measures. The sac and the stalk where the lump comes from must be removed entirely. Otherwise, the cyst may return after surgery.
Some ganglion cysts can also be removed arthroscopically.