Ganglion cyst
A ganglion is a benign cystic lesion arising from a joint or tendon sheath. It contains gelatinous fluid and has no true epithelial lining.
Common sites
- dorsal wrist
- volar wrist
- flexor tendon sheath
- distal interphalangeal region as mucous cyst
Management
- reassurance for asymptomatic lesions
- aspiration in selected cases, acknowledging recurrence risk
- surgical excision for persistent pain, functional limitation, nerve compression or recurrent symptomatic lesions
Giant cell tumour of tendon sheath
A giant cell tumour of tendon sheath is a benign proliferative lesion of synovial origin, usually presenting as a firm slow-growing hand mass.
Features
- usually painless
- commonly occurs around fingers
- may erode adjacent bone by pressure
- histology demonstrates multinucleated giant cells, histiocytes and hemosiderin
Treatment
Complete local excision is the treatment of choice. Recurrence may occur, particularly after incomplete excision.