We see many patients who have lumps and bumps in their hand that are painful, growing, affect function, and are often worry some for the patient due to the concern for cancer. If you are concerned about a hand tumor, wrist mass, or finger cyst, you should schedule a consultation to put your mind at ease with a diagnosis and to discuss treatments available.
Fortunately, many of these types of growths are benign (non-cancerous), but a surgeon should evaluate all abnormal growths. An abnormal growth is considered to be a “tumor” but that doesn’t mean that it is a cancer. Most growths of the hand and wrist occur on or just under the skin, like a mole, wart, or simple cysts, but some can form underneath the skin and involve the fat layer, the muscle, or even the bone tissue. Since the hand and wrist have many different types of tissues, there are many different types of tumors that can occur.
Inclusion Cyst
These are small masses that develop after an injury to a finger or the hand but often do not show up until years later. An inclusion cyst forms just underneath the skin and is non-cancerous. The surface cells are pushed into the deep layers of the palm or finger resulting in the formation of a mass in the area of injury. When the skin cells are injured, they produce a protective waxy substance called keratin, which helps to form these types of cysts. I frequently remove these masses with a relatively straightforward procedure resulting in permanent mass removal.
Ganglion Cyst
The most common form of hand tumor is the ganglion cyst (pronounced gang-lee-ahn). These arise from the capsule of a joint or sheath of a tendon. They can be found at different places on the hand and wrist areas and are harmless growths. Ganglion cysts contain a clear, thick, mucus-like fluid similar to the fluid of the joints. They often occur on people who have repeated stress applied to the wrist and hands. Most ganglion cysts are removed through outpatient surgery. This procedure includes removing part of the involved joint capsule or tendon sheath to eliminate the pain caused from the cyst and to prevent recurrence.
Giant Cell Tumor of the Tendon Sheath
Giant cell tumors are firm masses that develop front the joint lining or from a tendon sheath. These common growths are quite painful and grow slowly. Again, I often remove these masses but it is important to note that this mass, though not cancerous, can recur.
Enchondroma
An enchondroma (pronounced in-kon-drome-ah) forms when cartilage grows inside the bone. This is another non-cancerous growth that can produce pain. These are problematic, however, when the tumor weakens the bone and leads to a pathologic fracture. With advanced enchondromas, surgical excision can decrease symptoms and fracture susceptibility.
Carpal Boss
This type of growth isn’t a tumor, but rather an overgrowth of bone on the back of the hand. Carpal Bosses are similar to bone spurs and are often mistaken for ganglion cysts. The carpal boss is more firm and non-moveable, however. If these masses become problematic, occasionally we may discuss the pros and cons of various forms of treatments including steroid injection to mass removal. This, unfortunately, can also recur.
All in all, masses in the hand are common and often quite curable. Occasionally, recurrence can occur, but rarely do these masses turn out to be cancerous. Mostly, they are unsightly and painful and can interfere with function.
Do not hesitate to schedule a consultation to alleviate your concerns about your hand mass!
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