Dr. Pedro Loredo is a hand surgeon/specialist serving the Dallas and Fort Worth, TX area. Call today to learn about treatment options for tumors of the hand.
What are Hand Masses and Tumors?
Masses and tumors of the hand and wrist are usually harmless and may not require treatment if they do not interfere with normal hand/wrist function or cause pain or discomfort. However, some masses and tumors can grow to become painful and interfere with everyday tasks at which point treatment becomes necessary.
There are several types of masses and tumors:
GANGLION CYSTS
Ganglion Cysts are benign masses caused by leakage of synovial fluid from the joints into the nearby surrounding soft tissue. These masses most often develop around the joints and tendons of the hands and wrists but can also occur on the ankles and feet.
The most common location is on the back of the wrist. They can become painful if they press on nearby nerves and can interfere with joint movement depending on their size and location. The symptoms associated with Ganglion Cysts include a visible lump near the joint (although some Ganglion Cysts are small enough that they may not be visible); pain, numbness or weakness if pressing on a nearby nerve; and/or interference with joint movement.
GLOMUS TUMORS
Glomus Tumors are rare, benign masses that form due to abnormal growth of tissue in the Glomus Body, a component within the dermis layer of the skin. They most often occur on the fingertips, under the nails, or on the wrists or feet. They tend to be very small, solitary, and bluish or whitish in color.
The symptoms associated with Glomus Tumors include a visible bluish or whitish bump or lesion on the hands, wrists, or feet; pain or sensitivity (especially if placed in cold water); or elevation of the nail bed if growing underneath the nail.
ENCHONDROMA
Enchondromas are benign tumors that form in the cartilage which lines the inside of the bones. Very often these tumors are relatively harmless, cause no symptoms and go undiagnosed.
Enchondromas most often occur in the small bones of the hands and feet. They are usually painless and exist with no symptoms at all. However, they can cause a deformity of the bone.
CARPAL BOSS
A Carpal Boss is a small, bony mass on the carpometacarpal joint at the back of the hand near the wrist. These masses often form due to trauma to the back of the hand/wrist, causing irritation of the carpometacarpal joint and tendons on the back of the hand.
The symptoms associated with Carpal Bosses include a visible lump at the at the back of the hand near the wrist accompanied by pain if the extensor tendons in the back of the hand are sliding over the bump.
MUCOUS CYSTS
Mucous Cysts are small, fluid-filled masses which form on the last joint of the finger just below the nail bed and are associated with osteoarthritis. Mucous Cysts typically affect people between the ages of 50 and 70. They can often be left alone and do not cause any harm to the patient, but in some cases can cause pain and/or nail deformity.
GIANT CELL TUMOR
Giant Cell Tumors are aggressive benign bone tumors which typically grow on the inside of the middle or index fingers or the palm of the hand. These tumors can become very painful and make it difficult to bend the affected finger(s) or hand. The symptoms associated with Giant Cell Tumors include a visible lump on the volar (palm) side of the hand or fingers; pain in the affected area(s); and/or interference with joint and hand movement.
PYOGENIC GRANULOMA
Pyogenic Granulomas are relatively common benign skin growths which appear deep red in color. They can have smooth surfaces or very uneven surfaces (similar to the look of ground meat). They often grow rapidly and bleed easily if the trauma is sustained because they are so rich in blood vessels. They are most commonly seen in children and pregnant women. The symptoms associated with Pyogenic Granulomas include a visible growth on the hand or upper extremities (although they can occur on any part of the body) which is deep red in color and may bleed easily if the trauma is sustained. They can be painful if disturbed.
LIPOMA
A Lipoma is a benign tumor or growth which is largely comprised of fat cells and develops just below the skin (subcutaneous). They are usually painless, can be easily seen and felt, are soft or rubbery feeling to the touch, and are slow-growing. The symptoms associated with Lipomas include a visible lump which is soft or rubbery feeling to the touch. In most cases, Lipomas are painless and do not interfere with everyday function. However, they can grow large enough to cause pain if they are pressing on a nearby nerve and can also impact movement.
Dr. Loredo’s Approach to Treating Masses and Tumors
TREATMENT FOR GANGLION CYSTS
Dr. Loredo will utilize ultrasound to determine if the mass is indeed a Ganglion Cyst. Depending upon the size, location and severity, he will either drain the fluid from the mass using a needle or he will surgically remove the mass using a minimally-invasive procedure.
TREATMENT FOR GLOMUS TUMORS
Dr. Loredo will evaluate the nature of the mass via physical examination, X-ray or ultrasound. If it is determined that the mass is a Glomus Tumor, he will recommend surgical removal. If the mass is growing under the fingernail, removal of the nail plate will be necessary to access it. However, the nail plate will be sutured back into place after the removal and usually returns to its normal appearance within 3-4 months post-surgery.
TREATMENT FOR ENCHONDROMA
If enchondroma is causing symptoms and/or weakening the bone, Dr. Loredo will perform curettage (scraping of the tumor from the bone cartilage).
TREATMENT FOR CARPAL BOSS
Dr. Loredo will evaluate the nature of the mass via physical examination, X-ray or ultrasound. If it is determined that the mass is a Carpal Boss which is causing pain or other symptoms, he will recommend surgical removal using a minimally-invasive procedure.
TREATMENT FOR MUCOUS CYSTS
Dr. Loredo will evaluate the nature of the mass via physical examination, X-ray or ultrasound. If it is determined that the mass is a Mucous Cyst which is causing pain or other symptoms, he will recommend surgical removal using a minimally-invasive procedure.
TREATMENT FOR GIANT CELL TUMOR
Dr. Loredo will perform a physical examination and utilize ultrasound if necessary. If it is determined that the mass is a Giant Cell Tumor, he will then recommend surgical removal using a minimally-invasive procedure.
TREATMENT FOR PYOGENIC GRANULOMA
Dr. Loredo will examine the mass and if it is determined to be a Pyogenic Granuloma will chemically remove it with silver nitrate in the office. In some cases, surgical removal using a minimally-invasive procedure is necessary.
TREATMENT FOR LIPOMA
Dr. Loredo will evaluate the nature of the mass via physical examination or ultrasound. If it is determined that the mass is a Lipoma which is causing pain or other symptoms, he will recommend surgical removal.
What Can I Expect After Surgery?
Recovery time for each procedure will vary and will be dependent upon the severity of the condition, but in general, patients can expect a recovery period of about one week for basic masses and two weeks for tendon masses. Dr. Loredo uses the most advanced, minimally-invasive techniques available and most patients are able to enjoy instantaneous relief from pain with faster post-operative recovery times.
Frequently Asked Questions
Can masses or tumors grow back once they are removed?
Yes, certain types of masses, such as Giant Cell Tumors, tend to have a higher rate of recurrence, while others, such as Ganglion Cysts, Pyogenic Granulomas, and Lipomas, have extremely low rates of recurrence. Dr. Loredo will discuss the rate of recurrence with each patient before the procedure is performed.
Will any of the masses or tumors described above cause me pain or discomfort?
Most of the masses or tumors described above cause very little to no pain at the onset but can grow large enough to compress nerves or joints and cause a great deal of pain. Others may never cause any pain or discomfort. The level of pain or discomfort varies on a case-by-case basis.
Are any of the masses or tumors described above dangerous?
Most of the masses or tumors described above are benign and relatively harmless, at the most causing slight pain or discomfort accompanied by an unsightly appearance. However, it is important to have any mass or tumor examined and evaluated by a medical professional as soon as it is identified to determine its nature and severity.
Contact the Loredo Hand Care Institute
If you are experiencing any of the symptoms associated with masses or tumors or would like to learn more about our practice in the Dallas area, please contact us today to schedule an appointment or get your free insurance check.
