Pediatric Ganglion Cysts: Case Series and Review of the Literature

Background: Although there is an abundance of information about hand and wrist ganglion cysts in the adult patient population, there is limited data about these lesions in children. The purpose of this article is to present our clinical experience and review the epidemiology, etiological factors, clinical presentation, treatment, and outcomes of pediatric patients with hand and wrist ganglion cysts. Methods: A literature review was thoroughly conducted along with a chart review of all cases of ganglion cysts operated on at a single institution, University Hospital, between May 2014 and October 2015. Results: Five consecutive patients, between ages 2-16 years, who presented with symptomatic lesions of the hand or wrist, underwent treatment by a single surgeon (R.D.). The mean age of patients was 9.4 years, with one of the patients being female. Functional limitation was the most common indication for surgical treatment. Only one patient had a history of previous trauma. In 80% of the cases, the diagnosis was made clinically. The most common site of occurrence was the dorsal wrist (4/5), followed by the volar wrist. Surgical excision was the treatment of choice for all patients that presented with symptomatic lesions (100%). Patients were followed up on one week post-operatively and told to return if they developed any recurrences. Conclusions: While observation has been reported to be worthwhile in the cases of the asymptomatic pediatric hand and wrist ganglia, surgical excision should be employed in those lesions that are symptomatic or do not resolve with observation alone.