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Provider giving a patient ultrasound treatment

If you have a lump on your hand or wrist, it's important to have it properly diagnosed. At the Penn Integrated Hand Program, we have orthopaedic, oncologic and plastic surgeons who specialize in treating lumps on hands. They will perform a careful assessment of your lump and determine the right treatment plan for you.

If you have a lump on your hand, contact us today for an evaluation.

Ganglion Cysts Surgical and Non-Surgical Options

Lumps on the wrist or hands that are benign are called ganglion cysts or bible cysts. Once our surgeons determine the lump or mass on your hand is a ganglion cyst, they will often recommend a wait-and-see approach if you do not have any symptoms of pain, numbness, tingling or decreased range of motion.

If it does not go away and you begin to experience symptoms that bother you, we may recommend a non-surgical approach or surgery.

Non-surgical Ganglion Cyst Treatment

  • Medication and splinting - If you’re experiencing pain, we may recommend an anti-inflammatory medication and splinting to decrease the pain.
  • Aspiration - In some cases, the fluid in the ganglion cyst can be removed through aspiration. During aspiration, we numb the area around the cyst with a local anesthetic and puncture the cyst with a needle, so fluid can be drained. Aspiration shrinks the cyst. However, it may end up coming back if the cyst’s connection to the joint or tendon sheath — its root — is not removed.

Ganglion Cyst Surgery

If non-surgical approaches do not alleviate your pain, our hand surgeons may discuss surgical removal of the cyst. We can help you decide if surgery makes sense.

  • Arthroscopic excision - We specialize in arthroscopy, which is a minimally invasive surgical technique. During an arthroscopic excision, we look into your wrist with a small camera and small tools. Through a very small incision, our surgeons can remove the cyst by cutting out the stalk. The cyst will disappear on its own once the stalk is removed.
  • Open excision - During an open excision of the cyst, there is no use of a camera, and we make a larger incision on top of the cyst to remove it. We remove the stalk that comes from the joint or the tendon sheath to decrease the possibility of it growing back.

What are ganglion cysts?

Ganglion cysts are sacs of fluid that form around joints and tendon sheaths as a result of joint or tendon irritation or trauma. They are usually oval or round and may be soft or firm. 

As they often develop in areas where a joint or tendon naturally bulges out of place, ganglion cysts are most commonly located on the back of the wrist or on the front of the wrist by the thumb at the base.

What are the symptoms of a ganglion cyst?

Sometimes ganglion cysts do not produce symptoms. In most people, they will come and go depending on your level of activity: they can increase in size when you are active and decrease in size when you rest.

Other times they can cause pain or discomfort. They can also cause numbness and tingling when they push on some of your small sensory nerves.

Who can get a ganglion cyst?

Anyone can develop a ganglion cyst. It can affect men and women of any age.

If you have a growth on your hand or wrist, please contact the Penn Integrated Hand Program for an evaluation.

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