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Ganglion cysts are non-cancerous, fluid-filled sacs that most frequently appear on the top of the wrist, and less frequently on the palm side of the wrist or on a finger. Ganglion cysts are quite common.
The exact cause of ganglion cysts is not known. It is important to stress that they have never been associated with cancer. They are simply sacs of fluid arising from an adjacent joint or tendon sheath.
A lump filled with a jelly-like substance on the wrist or hand--most commonly on the back side of the wrist, but also on the palm side, the end joint of a finger or the base of a finger, may indicate a ganglion cyst. These lumps can fluctuate in size or even disappear. They can also be painful, especially with strenuous use of the hand, and motion of the adjacent joints may be limited.
Ganglion cysts often do not require treatment, but should be checked out by a physician nonetheless. If the cyst is painful or interferes with normal joint activity, or if the patient is displeased with its appearance, treatment will generally be recommend.
A physical exam and history is usually enough to diagnose a ganglion cyst. A physician generally bases the diagnosis on the cyst's location and shape. The cysts are not adherent to the skin, but rather are attached to a joint or tendon sheath underneath the skin. The beam of a pen light will usually shine through (i.e. transilluminate) the cyst unlike a solid tumor. Sometimes, a hand surgeon will recommend x-rays to rule out problems in nearby joints.
If the ganglion is not causing pain or limited motion, the physician may opt to simply observe the mass for a period of time for any changes. If the cyst is painful or interferes with activity--or if the patient finds its appearance unsightly--other treatment options are available.
Immobilizing the wrist with a splint may help, especially if the cyst is diagnosed early. A physician can also withdraw the fluid from the cyst with a needle (aspiration) in order to minimize symptoms, but the patient must realize that since the stalk or conduit from the joint to the cyst still remains, recurrence is the norm after simple aspiration.
If other treatments fail, a physician can surgically remove the ganglion cyst as an outpatient procedure. Since the surgeon is removing the source of the cyst, a portion of the joint capsule or tendon sheath adjacent to the ganglion may need to be removed as well. A splint may be recommended following a ganglion removal from the wrist, and patients often experience mild pain, tenderness and swelling for several days to weeks after surgery. Patients may resume normal activities as soon as it is comfortable to do so--usually by two weeks for ganglions of the finger and by four to six weeks for ganglions involving the wrist.
It should be noted that while surgery offers the most reliable method of removing ganglions, the cysts occasionally reoccur even with a successful surgery.
