A painless lump on the wrist that recurs is most consistent with which diagnosis?

A painless lump on the wrist that recurs is most consistent with which diagnosis?

• A. Lipoma
• B. Cystic Tumor
• C. Ganglion Cyst
• D. Epidermoid Cyst

Answer: (C)

A ganglion cyst is the best fit because it is the most common soft tissue lump of the wrist and arises from a joint capsule or tendon sheath. It typically presents as a smooth, painless, fluctuant mass on the dorsum of the wrist and is well known for recurring after aspiration or drainage due to a persistent connection (stalk) to the joint or sheath. Lipomas are usually soft, mobile subcutaneous masses not specifically tied to joint/tendon structures and don’t characteristically recur in this manner. Epidermoid cysts are firmer, often have a punctum, arise from epidermal tissue rather than a joint or tendon, and aren’t the classic cause of a recurrent wrist lump. A generic “cystic tumor” lacks the typical wrist-specific recurrent pattern of a ganglion cyst.

A ganglion cyst is the best fit because it is the most common soft tissue lump of the wrist and arises from a joint capsule or tendon sheath. It typically presents as a smooth, painless, fluctuant mass on the dorsum of the wrist and is well known for recurring after aspiration or drainage due to a persistent connection (stalk) to the joint or sheath. Lipomas are usually soft, mobile subcutaneous masses not specifically tied to joint/tendon structures and don’t characteristically recur in this manner. Epidermoid cysts are firmer, often have a punctum, arise from epidermal tissue rather than a joint or tendon, and aren’t the classic cause of a recurrent wrist lump. A generic “cystic tumor” lacks the typical wrist-specific recurrent pattern of a ganglion cyst.