Hand Tumours and Lumps

A hand tumour is any lump or growth in the hand or wrist. The great majority are benign. The most common are ganglion cysts, giant cell tumours of the tendon sheath, epidermal inclusion cysts, lipomas and, in bone, enchondromas. Skin cancers on the back of the hand are fairly common in sun-exposed older adults, while sarcomas of the hand are rare.

Most lumps need only a confident diagnosis and, if they are troublesome, a small operation. The important task is to recognise the few that are not benign before any surgery, because an unplanned excision of a sarcoma makes later treatment harder.

Symptoms

• A smooth, round swelling near the wrist or a finger joint that may change in size
• A firm, slowly growing nodule on the side of a finger
• A lump that is painful when knocked or in cold weather, sometimes under a nail
• Tingling or numbness if a nerve is pressed
• A finger that breaks after a trivial injury because of a cyst within the bone
• A scaly, ulcerated or bleeding patch of skin that does not heal
• A deep, enlarging or painful mass, which needs prompt assessment

Causes and risk factors

Ganglion cysts form from joint or tendon sheath lining and contain thick fluid; they are often linked to wear or minor strain. Giant cell tumours of the tendon sheath are benign overgrowths of the lining tissue. Inclusion cysts follow small penetrating injuries. Enchondromas are islands of cartilage left within bone. Glomus tumours arise from tiny temperature-regulating structures under the nail. Squamous cell carcinoma relates to cumulative sun exposure and weakened immunity. For the rare sarcomas, no cause is usually found.

How it is diagnosed

• Examination: Position, consistency, whether light shines through the lump and how it moves with the tendons often give the diagnosis.
• X-ray: Shows bone tumours such as enchondroma, erosion from nearby masses and calcification.
• Ultrasound: Tells a fluid-filled cyst from a solid mass and shows its relation to tendons and vessels.
• MRI: Used for solid, deep, large or uncertain masses, and before surgery on anything that might be malignant.
• Biopsy: Performed for suspicious lesions before removal, planned with the surgeon who would do the definitive operation.

Treatment options

• Observation: Painless ganglions and small stable lumps can be left alone. Many ganglions shrink by themselves.
• Aspiration: Drawing off the fluid from a ganglion with a needle. Simple, but the cyst returns in about half of cases.
• Surgical excision: Day-case removal under local or regional anaesthetic for painful or enlarging lumps. Giant cell tumours of the tendon sheath can recur if fragments remain.
• Curettage and bone grafting: For enchondromas that cause pain or fracture.
• Wide excision and reconstruction: For skin cancers and sarcomas, sometimes with skin grafts, flaps, or partial amputation, along with radiotherapy for sarcoma.
• Hand therapy: Exercises and splinting after surgery to restore movement.

When it is urgent

A hand lump is seldom an emergency. Seek urgent local care for a hot, red, rapidly swelling hand or finger with fever, which suggests infection, for sudden loss of feeling or colour in a finger, or for a fracture. A mass that is growing quickly, is larger than about 5 centimetres, deep, or painful at night should be seen by a specialist within 2 weeks.

Travelling to Türkiye for treatment

Removing a benign hand lump is a short planned procedure that fits easily into a visit of 4 to 7 days, including a wound check. Stitches usually come out at 10 to 14 days and can be removed at home. Hand therapy afterwards is best done locally. If a sarcoma is suspected, do not have the lump simply cut out; ask for imaging and a planned biopsy by a tumour team, and consider where the whole course of care, including radiotherapy, will take place.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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