Hand and Wrist Tumors

Most lumps and bumps in the hand or wrist are benign, but a hand specialist can help identify the type of mass and whether observation, imaging, biopsy, or treatment is needed.

Any abnormal lump or bump in the hand or wrist is considered a tumor. The term tumor does not necessarily mean it is malignant or that it is a cancer. In fact, most hand and wrist tumors are benign, meaning they are not cancer.

Tumors can occur on the skin, such as a mole or a wart, or underneath the skin in the soft tissue or even the bone. Because there are many types of tissue in the hand, including skin, fat, ligaments, tendons, nerves, blood vessels, and bone, many different types of tumors can occur. Only a few of them are seen commonly.

Common Types of Tumors

  • Ganglion cysts: These are the most common tumors in the hand and wrist. Ganglion cysts are seen frequently in the wrist but can occur at the base of the fingers or around finger joints. The cyst is typically filled with fluid and may feel very firm. Treatment options may include observation, aspiration with a needle, or surgical removal.
  • Giant cell tumor of the tendon sheath: This is the second most common hand tumor. Unlike fluid-filled ganglion cysts, these tumors are solid. They are benign and slow-growing.
  • Epidermal inclusion cyst: This benign tumor forms just underneath the skin where there may have been a cut or puncture. The cyst is filled with keratin, a soft, waxy material.

Other less common tumors seen in the hand include lipomas, neuromas, nerve sheath tumors, fibromas, glomus tumors, and others. Almost all are benign.

Causes

Foreign bodies, such as a splinter, can cause reactions that form bumps in the hand. Dupuytren's contracture may cause firm bumps in the hand, which are often confused with tumors. Blood vessel growths can also be confused with other tumors.

Diagnosis

A physical exam and review of your medical history by a hand surgeon can help determine the type of hand or wrist tumor you may have. X-rays may 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, which removes a small sample of the tumor, may be considered if the surgeon wants to confirm the diagnosis before recommending treatment.

Treatment

Typically, the most successful treatment is removing the tumor with surgery. This allows a pathologist to analyze it and determine the type of tumor. Often, surgery is done on an outpatient basis.

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, such as skin discoloration, pain, or increased size, or if it causes other problems such as numbness or pain from pressure on a nearby nerve, re-evaluation by a hand surgeon is recommended.

You and your hand surgeon can choose the best treatment plan.

When to seek care: A new, changing, painful, enlarging, or symptomatic lump in the hand or wrist should be evaluated, especially if it causes numbness, pressure, skin changes, or difficulty using the hand.