Hand & Wrist Tumors
Hand tumors or masses are common. The majority of hand tumors are benign, meaning they are not cancer. When malignant, or cancerous, and tumors do form, most of these tumors are types of skin cancer. Cancers within deeper tissues of the hands or bones are rare.
Our hand surgeons in the Division of Plastic and Reconstructive Surgery are well versed in the treatment of masses in the hand. You should make an appointment with your doctor if you feel a mass (or bump) in your forearm or hand. You can be evaluated by any of our hand surgeons who can help diagnose and remove these masses.
Ganglions Cysts
One of the most common types of benign (non-cancerous) hand and wrist masses is a ganglion cyst. Ganglion cysts are bumps filled with a clear jelly-like joint fluid. Ganglions often form on the back of the wrist or on the wrist where you can feel your pulse. They can also form on the joints of your fingers (mucous cysts). Cysts at the end of your fingers may cause your nail to grow funny or have a dent. They can be painful, particularly when doing activities where you bear weight on an extended wrist, like during a pushup, yoga, or a plank.
What Causes Ganglion Cysts?
Ganglions usually form in joints when joint fluids escape from the joint. They may be related to arthritis, but even young people can develop ganglion cysts. The cysts cause a mass or bump to form underneath your skin. The mass may change in size. Although they are filled with fluid, they are sometimes quite firm.
How are Ganglion Cysts Diagnosed?
Your provide diagnoses ganglion cysts by asking your medical history and performing a physical exam. A fun test is to shine a light through the mass and see if it lights up. This shows that the mass is a fluid-filled cyst rather than a solid tumor. An ultrasound can also be used to diagnose a ganglion cyst. We perform ultrasounds in many of our hand surgery clinics.
How are Ganglion Cysts Treated?
If you are not bothered by the cyst, it is perfectly reasonable to do nothing and continue to observe it. If the cyst causes you pain or discomfort you may want to remove it.
One form of treatment is to aspirate (remove) the fluid from the mass using a needle. Masses will often return with this method of treatment. Aspiration is not recommended for cysts located near your radial artery due to the risk of injuring your artery.
The mass can also be surgically removed. Surgical removal of a ganglion cyst involves making an incision (cut) directly over the mass. The mass is removed and the stalk arising from the joint is treated to help prevent your mass from returning.
Some surgeons prefer to do an arthroscopically assisted ganglion cyst excision. This procedure uses a camera placed in your joint to address the stalk. While this doesn’t necessarily mean a smaller incision, it may mean that your surgeon gets a direct view of wrist arthritis which can help diagnose other sources of your wrist pain.
