Tumors of the Hand and Wrist

What it is

Any abnormal lump or bump in the hand is called a tumor. Most hand and wrist tumors are benign. Because the hand contains skin, fat, tendons, nerves, blood vessels, and bone, many types of tumors are possible, but only a few are common.

Common types

• Ganglion cyst: the most common, a firm, fluid-filled cyst
• Giant cell tumor of the tendon sheath: the second most common, a solid, slow-growing benign tumor usually removed surgically
• Epidermal inclusion cyst: a waxy-filled cyst under the skin, often at the site of an old cut or puncture
• Lipomas, nerve tumors (schwannomas), fibromas, and glomus tumors: less common and almost always benign
• Enchondroma: the most common growth inside the small bones of the hand. Usually observed, but treated if the bone breaks or the growth is large.

Cancerous tumors

Skin cancers such as melanoma and squamous cell carcinoma can occur on the hand or under the nail. Melanoma under the nail can look like a dark stripe; squamous cell cancer can look like a scaly patch that does not go away. Sarcomas, cancers of the deep soft tissue, are rare. They are often painless and slow growing, and are evaluated with MRI and a biopsy, sometimes with a sarcoma specialist.

Diagnosis and treatment

An examination and history, X-rays, and sometimes ultrasound, CT, MRI, or a bone scan help identify the tumor. A needle or small incisional biopsy may be done to confirm the diagnosis before treatment.

The most successful treatment is usually surgical removal, often as an outpatient, which also lets a pathologist confirm the type of tumor. Some people choose to live with a lump once they know it is not cancer. If a lump changes color, becomes painful, grows, or presses on nearby structures, have it re-evaluated. Other causes of lumps include splinters and Dupuytren's disease.