Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons. The most common locations are the top of the wrist, the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. The ganglion cyst often resembles a water balloon on a stalk, and is filled with clear fluid or gel. The cause of these cysts is unknown although they may form in the presence of joint or tendon irritation or mechanical changes. They occur in patients of all ages.
These cysts may change in size or even disappear completely, and they may or may not be painful. These cysts are not cancerous and will not spread to other areas..
Treatment options include observation, aspiration, and surgical removal of the cyst. In many cases, these cysts can simply be observed, especially if they are painless, as they frequently disappear spontaneously. If the cyst becomes painful, limits activity, or is otherwise unacceptable, several treatment options are available.
- Aspiration can be performed to remove the fluid from the cyst and decompress it. This requires placing a needle into the cyst, which can be performed in the office. Aspiration of the cyst has a high recurrence rate.
- Surgical resection – Surgery involves removing the cyst along with a portion of the joint capsule or tendon sheath. Both traditional open and arthroscopic techniques usually yield good results. Surgical removal of the cyst has the lowest rate of recurrence out of all treatment options.