If you have a bump on your wrist or hand, you might wonder where it came from. You might wonder if it’s dangerous or even cancerous. Luckily, the most common type of bump on the wrist is called a ganglion cyst, and it is not a sign of cancer.
If you’re worried about what that mass on your hand is, here’s an easy way to tell. Place a small flashlight directly over the bump. If light shines all the way through it, it’s probably a ganglion cyst.
However, many types of masses can appear on the hand and wrist, and not all are as harmless as ganglion cysts. This is your guide to hand and wrist lumps and bumps—what they are, and what to do about them.
What Is a Ganglion Cyst?
Ganglion cysts are a type of tumor. That doesn’t mean “cancer,” it just means “growth.” Ganglion cysts are benign tumors, meaning they are not cancerous (malignant).
Ganglion cysts are masses that form along the tendons or joints of the wrists and hand. They are filled with a thick, translucent fluid. That’s why light shining through a mass usually indicates a ganglion cyst—the light would not shine through if it was a solid mass.
Visually, they look like round, raised bumps under the skin. They are generally not discolored and can range from pea-sized to quarter-sized or larger. About 80% of the time they appear on the back of the wrist, but they may also be found in the front of the wrist near your thumb or even in your fingers.
Ganglion cysts are pockets of joint fluid that escape from a nearby joint. The exact cause of ganglion cysts is unknown; however, there are certain risk factors. People who develop ganglion cysts are more likely to:
- Be between the ages of 20 and 40
- Be female
- Have had joint or tendon injuries
- Have osteoarthritis
Diagnosing Ganglion Cysts
I diagnose ganglion cysts in much the same way I tell my patients to check at home. They are usually not tender, somewhat moveable, and located right under the skin. I aim a beam of light at the cyst and try to determine if it’s solid or if it’s filled with liquid. While ganglion cysts themselves are painless, patients may have pain when extending the wrist in the pushup position.
If a physical exam is inconclusive, some imaging tests such as X-rays or magnetic resonance imaging (MRI) can help me rule out other conditions that might be causing the mass in the hand, such as a tumor. Finally, if the cyst seems to be filled with liquid, I can withdraw some of the liquid with a needle and test it. This process is called aspiration and is generally used only for large cysts.
Ganglion Cyst Treatment
Often, ganglion cysts will go away on their own, with no treatment necessary. Aspiration may make the cyst smaller but it still may come back.
Do not attempt to treat the cyst yourself. Friends and family may advise you to try hitting the cyst with a hard, heavy object, or squeezing or stabbing it until it pops. Smashing the cyst will probably just injure your hand or wrist, and trying to pop it may lead to infection.
If aspiration and immobilizations do not work, surgery may be warranted. I can surgically remove the cyst and its stalk, the tissue that attaches to the joint or tendon. Surgery to remove a ganglion cyst can be performed as an open procedure—with a comparatively large incision—or as a minimally invasive procedure, with small tools, smaller incisions and a flexible camera attached to a video monitor. Both approaches usually work well.
Other Masses on the Hand
While ganglion cysts are the most common types hand tumor, they are far from the only type. Other common types of benign hand tumors include:
- Giant cell tumor of the tendon sheath.
- Inclusion cyst
The majority of hand and wrist tumors are benign. However, there are other types of masses that can be much more serious. The most common malignant tumors on the hand and wrist are skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. These generally look nothing like ganglion cysts, appearing more like open sores, moles or infections. Other malignant hand masses can be tumors of the bone (osseous tumors) or cartilage (chondroma).
If you have a suspicious lump on your hand, chances are it’s a harmless ganglion cyst. However, it’s best not to take your chances. You’ll still want to schedule an appointment with me. Together we’ll determine the type of mass and what treatment, if any, it requires.