Common Types of Wrist Tumors and Hand Tumors

• Ganglion Cysts (Figure 1): This is the most common wrist and hand tumor. Ganglion cysts are seen frequently in the wrist but can occur at the base of the fingers or around the finger joints. The cyst is typically filled with fluid, and it will feel very firm. There are several treatment options for a ganglion cyst, including observation (doing nothing), aspiration (puncturing with a needle) or surgically removing it.
• Giant cell tumor of the tendon sheath (Figure 2): This is the second most common hand tumor. Unlike the fluid-filled ganglion cyst, these tumors are solid. They are benign (not cancer) and slow-growing.
• Epidermal inclusion cyst (Figure 3): This tumor is benign and forms just underneath the skin where there may have been a cut or puncture. The cyst is filled with keratin, a soft, waxy material.

There are other less common types of tumors seen in the hand, including lipomas (fatty tumors), neuromas (nerve tumors), nerve sheath tumors, fibromas and glomus tumors, among others. Almost all are benign.

A physical exam and review of your medical history by a hand surgeon can help to determine the type of wrist or hand tumor you may have. X-rays might be taken to evaluate the bones, joints and possibly the soft tissue. Further studies such as ultrasound, CT, MRI or bone scans may be done to help narrow down the diagnosis. Needle biopsy or incisional biopsy (cutting out a small sample of the tumor) may be considered if the surgeon wants to confirm the diagnosis before recommending treatment.

Some patients may choose to do nothing and simply live with the tumor once they learn that it is non-cancerous. However, if the tumor changes (e.g. skin discoloration, pain, increased size) or if it causes other problems such as numbness or pain from pressure on a nearby nerve, then re-evaluation by a hand surgeon is recommended. You and your hand surgeon can choose the best treatment plan.