The Symptoms, Types, and Prognosis of Hand Tumors

Growths on the hand and wrist are fairly common and are often described as lumps, nodules, tumors, or cysts. They are usually not cancerous, but they could be uncomfortable. And because they are located in such a visible area of the body, they can be unsightly—and may make you feel self-conscious. 

Most of the time, a tumor in this location can be diagnosed based on its appearance and texture. An imaging study such as an X-ray can help with distinguishing the different types of hand and wrist growths from each other. Sometimes a biopsy may be needed to identify the type of tumor growth and to help in developing your treatment plan. 

What to Do About Your Hand or Wrist Tumor 

There are several types of growths that can appear on your hand or wrist. Usually, these tumors don’t cause any symptoms besides their visible manifestation, although sometimes they can be accompanied by pain or limited movement.

They may emerge suddenly, and they tend to last for a long period of time, often persisting or even growing unless they are treated.

When to See a Doctor

The most common growths on the hand and wrist are not tumors. Nodules, rashes, warts, and infections are very common, and they often require medical treatment.

Most hand and wrist tumors are benign, which means that they are not expected to spread to other parts of the body, and they are not damaging to your health. But there are some rare cancers of the hand and wrist, so it is important to discuss any growths with your doctor even if you are not concerned about cosmetic issues or discomfort. 

If you have a growth on your hand or wrist, you should let your doctor know if you have similar growths elsewhere on your body. Your doctor will also ask whether you have had any trauma to the area and whether you feel any pain, tingling or difficulty with movement. 

Diagnostic Evaluation

Your doctor will examine your sensation and motor strength to determine whether you have any nerve impairment. Your blood flow will be evaluated based on your pulse and the color of your hands and fingers (if they are pale or bluish, you may have impaired blood flow).

You may need to have an imaging examination. Most of the time, an X-ray can identify whether your growth is fluid-filled, or whether it is composed of bone, cartilage, or soft tissue. If you need further imaging, bone scans and magnetic resonance imaging (MRI) tests are often used to visualize these types of tumors. 

If there is any concern about malignancy (aggressive cancer), you may need to have a biopsy of your tumor. A biopsy involves a surgical sample or a needle aspiration if the tumor is fluid-filled. The sample is examined under a microscope so that its pathological characteristics can be closely examined—this examination can identify whether the tumor is benign or malignant and what type of tumor it is. 

Ganglion Cyst 

A ganglion cyst is the most common type of hand and wrist tumor. It is estimated that between 10 to 30 percent of adults will develop a ganglion cyst at some point in their lives, most commonly between the ages of 20 and 40. It affects women approximately three times as often as men, and it rarely occurs in children. Most of the time, a person only has one ganglion cyst, but it is not unheard of to have more than one.

Generally, a ganglion cyst is a non-painful growth on a joint of the hand or wrist. Depending on its location, it can cause pain or limited movement in some instances. It is usually round, skin-colored, and about 1 centimeter to 3 centimeters in size. It may feel soft, but it is not mushy, and it can’t be moved around. A ganglion cyst is generally not tender to touch. 

Often, these cysts occur in the dominant hand (the one you use to write) and there may be an association with overuse. They are filled with fluid and can appear on the outside of your hand or wrist, or on your fingers. They may grow in size, eventually interfering with your movement. 

You can use ice or heat to relieve mild pain, and you can take oral (by mouth) pain relievers if necessary

Ganglion cysts may go away on their own. Your doctor may examine your cyst with an X-ray or an (MRI), especially if planning surgical treatment. Sometimes, aspiration is used to remove the fluid inside the cyst with a needle. In some instances, surgical removal can help.

Ganglion cysts have a tendency to return after treatment, and surgical resection is generally longer lasting than aspiration.

Giant Cell Tumors 

Tenosynovial giant cell tumors and pigmented villonodular synovitis (PVNS) are similar tumors, but PVNS is more aggressive. They have a similar microscopic appearance, with the presence of a type of cell called a giant cell.

Tenosynovial giant cell tumors are benign, growing on joints in the hands, arms, or legs. They are the second most common tumors of the hand. They are also called giant cell tumors of the tendon sheath or fibrous histiocytoma of tendon sheath.

PVNS is also called diffuse-type PVNS or diffuse-type giant cell tumor. PVNS may become larger than tenosynovial giant cell tumors, and are more likely to cause symptoms, such as limited movement of the fingers, hand, and wrist.

Your treatment depends on your symptoms, the size of the tumor, and whether there is any concern about malignancy.

Dupuytren’s Contracture

Dupuytren’s contracture is thickening of the connective tissue in the hand, often causing a lump or an uncomfortable contracture (involuntary bending) of the finger. You may have a thick knot under your skin, and it most commonly occurs between the palm and the ring finger or pinky finger.

Dupuytren’s contracture makes it difficult to move your hand and straighten your fingers.

This condition is diagnosed based on the position of the hand, and it tends to worsen over time. It is more common among older men and there is an association with smoking. It is usually treated with a combination of non-steroidal anti-inflammatory medication (NSAIDs), steroids, splint, and physical therapy. In severe cases, surgical treatment may be recommended.

Epidermal Inclusion Cysts

Epidermal inclusion cysts are soft skin growths. They are very common growths and can appear anywhere on the body, including the hands and wrists. 

They are usually firm, painless, and skin-colored. They are filled with keratin, a protein that is normally present in the skin.

This type of growth is harmless, but you can have it removed if it is bothering you due to its appearance or if it causes you to have pain or discomfort. 

Carpal Boss 

Carpal boss is an overgrowth of the bones near the wrist and index or middle finger. It can manifest as a hard bump on the back of your hand. 

This is a benign tumor that usually doesn’t produce symptoms besides the visible bony bump. However, as with most tumors, it can trigger discomfort if it presses on a nerve, blood vessel, or a joint.

If you have problems due to this bony growth, you may need therapy or a splint. In rare cases, surgical removal may be necessary if it causes severe pain or limitation of movement.

Enchondroma 

A benign cartilaginous tumor called an enchondroma can appear anywhere where you have cartilage, including your fingers. Your doctor may diagnose it based on its appearance or with an imaging test, such as an X-ray or bone scan. 

Enchondromas can grow deep in the body, near the cartilage from which they originated. Sometimes they aren’t clinically noticeable at all and maybe discovered incidentally when you have an imaging test for another reason. 

These tumors rarely become malignant, and if you don’t have any discomfort or signs of cancer, your doctor may recommend observing it periodically. 

Malignant Tumors 

Rarely, tumors of the hand or wrist can be malignant. Squamous cell tumors, chondrosarcoma, and synovial sarcoma are malignant tumors that can appear on the hand or wrist. 

As with most malignant tumors, they can grow quickly and they can be irregular in shape. Chondrosarcomas can appear similar to echondromas, and a biopsy or imaging tests may distinguish them.

If your doctor suspects that you may have a malignant tumor on your hand or wrist, you will need imaging studies to get a detailed image of the growth. A biopsy can identify the microscopic features of the tumor.

Removal of the tumor is usually necessary. After surgical resection, your tumor will likely be evaluated under a microscope so that your medical team will know if all of the malignant cells were removed. 

Recover After Hand and Wrist Surgery 

Sometimes, after hand surgery, nerves, muscles, or blood vessels may be impaired. This is more likely if you have a malignant tumor that infiltrated these structures because your surgeon will attempt to remove all harmful portions of the tumor— even if it means potentially affecting healthy structures. 

After any type of hand surgery, you should anticipate rehabilitation and physical therapy as you work to regain as much strength, coordination, and sensation in your hand and wrist as possible. 

A Word From Verywell

Your hands and wrists are the most active parts of your body. Fortunately, most tumors in this area are not harmful to your health. However, some of them are. And since you use your hands for so many things, it is important to pay attention to any growths before they cause problems. 

If you talk to your doctor, get the necessary tests, and decide to keep an eye on things, you must follow up regularly with your physician. Be sure to address the issue again if the tumor grows, becomes warm, red or discolored, or if you begin to experience pain, tingling, sensory loss, or weakness. 

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