hand masses & hand tumors

What Are Hand Masses and Tumors?

Hand masses, lumps, and bumps in and on the hand are very common.  Fortunately, most of these are benign (not cancer).  These are generically referred to as hand tumors.

Hand masses can occur on the skin, such as a mole or a wart. Hand tumors can develop underneath the skin in the soft tissue or even the bone. Because there are so many types of tissue in the hand (e.g. skin, fat, ligaments, tendons, nerves, blood vessels, bone, etc.), there are many types of tumors that can occur.  Depending on the type, a mass or cyst may or may not produce symptoms.

The most common hand masses are:

  • Ganglion cysts are benign fluid-filled hand masses that are typically seen on the wrist, hand, and fingers.  This is most common mass occurring in the hand.  There are several treatment options for a ganglion cyst, including observation (doing nothing), aspiration (puncturing with a needle) or surgically removing it.
  • Dupuytren’s nodules are hard, visible knots that form due to the thickening of the tissue beneath the skin in the palm of the hand. They are often painless, but may cause discomfort with gripping.  Nodules themselves do not alter function; however, development of a chord may lead to Dupuytren's contracture of the finger.
  • Epidermal inclusion cysts are benign and form just underneath the skin where there may have been a cut or puncture. The cyst is filled with keratin, a soft, waxy material.
  • Giant cell tumors of the tendon sheath are benign hand tumors most commonly found on the palmar surface of index, middle, and ring fingers. Over time, some giant cells tumors of the tendon sheath may become symptomatic and need to be excised.

There are other less common types of hand tumors, including lipomas (fatty tumors), neuromas (nerve tumors), nerve sheath tumors, fibromas, and glomus tumors, among others. Almost all are benign.

How are Hand Masses Diagnosed?

A physical exam and review of your medical history can help to determine the type of hand or wrist tumor you may have.  X-rays might 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. A biopsy may be considered confirm diagnoses.

How are Hand Tumors Treated?

Typically, the most successful treatment is removing the tumor with surgery. This allows a pathologist to analyze it and to 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 (e.g. skin discoloration, pain, increased size) or if it causes other problems such as numbness or pain from pressure on a nearby nerve, then re-evaluation is recommended.