What is a ganglion cyst and how is it treated?
A ganglion cyst is a type of benign cystic tumor. It generally originates near tendons and joints and can manifest anywhere in the musculoskeletal system. For example, the shoulder joint, elbow joint, hip joint, knee joint, and ankle joint. Sometimes it can occur within the bone and grow.
How do ganglion cysts present?
The most typical location is the back of the wrist. It usually appears as a painless, hazelnut- or walnut-sized, moderately hard mass on the back of the wrist. It can become painful or worsen after movements that require excessive wrist use. Pain becomes more pronounced when the cyst is compressed between the wrist bones and the pressure increases during upward wrist bending. The person avoids upward wrist bending, and upward wrist bending is restricted. Sometimes, the mass can present as wrist pain before it becomes visible.
How is it diagnosed?
Ganglion cysts are diagnosed based on the mass's typical location, appearance, and examination. A direct X-ray is taken to determine if there is a predisposing joint problem. In unusual locations, ultrasound and MRI may be necessary for definitive diagnosis. In cases of hidden ganglia (occult ganglia), where the cyst is not visible and is deeply located, diagnosis is made with MRI.
What is the natural history of ganglion cysts?
First of all, ganglion cysts are not malignant tumors and have no potential for malignancy. Even without treatment, a significant proportion of them heal and disappear spontaneously within the first 3-6 years. They are mostly painless. They are more likely to cause curiosity and aesthetic concern.
How is ganglion cysts treated?
If a ganglion cyst is causing aesthetic and pain discomfort, especially if the cyst has been present for 3-6 months, the most definitive and effective treatment is surgical removal. For effective treatment, the cyst and its attached stalk should be traced back to the joint capsule and ligaments, and the entire cyst should be removed without rupturing. The recurrence rate after successful surgery is very low. The procedure is performed under local anesthesia, and the patient is discharged the same day. A short-term splint is applied. The patient returns to their daily work and sports activities within a few weeks.