Ganglion Cyst Removal Health Article

Demographics

Ganglion cysts account for 50%–70% of all soft tissue tumors of the hand and wrist. They are most likely to occur in adults between the ages of 20 and 50, with the female: male ratio being about 3: 1. Most ganglion cysts are visible; however, some are occult (hidden). Occult cysts may be diagnosed because the patient feels pain in that part of the hand or has noticed that the tendon cannot move normally. In about 10% of cases, there is associated trauma.

Description

Patients are given a local or regional anesthetic in a doctor's office. Two methods are used to remove the cysts. Most physicians use the more conservative procedure, which is known as aspiration.

Aspiration

• An 18- or 22-gauge needle attached to a 20–30-mL syringe is inserted into the cyst. The doctor removes the fluid slowly by suction.
• The doctor may inject a corticosteroid medication into the joint after the fluid has been withdrawn.
• A compression dressing is applied to the site.
• The patient remains in the office for about 30 minutes.

Excision

Some ganglion cysts are so large that the doctor recommends excision. This procedure also takes place in the physician's office with local or regional anesthetic.

Excision of a ganglion cyst is performed as follows:

• The physician palpates, or feels, the borders of the sac with the fingers and marks the sac and its periphery.
• The sac is cut away with a scalpel.
• The doctor closes the incision with sutures and applies a bandage.
• The patient is asked to remain in the office for at least 30 minutes.

Diagnosis/Preparation

Ganglion cysts are fairly easy to diagnose because they are usually visible and pliable to the touch. They are distinguished from other growths by their location near tendons or joints and by their fluid consistency. Ganglion cysts are sometimes confused with a carpal boss (a bony, non-mobile spur on the top of the wrist), but can usually be distinguished by the fact that they can be moved and are usually less painful for the patient.

The doctor may schedule one or more imaging studies of the hand and wrist. An x-ray may reveal bone or joint abnormalities. Ultrasound may be used to diagnose the presence of occult cysts.