Images in Clinical Medicine

Giant Ganglion Cyst

Neil J. Mortimer, M.R.C.P., and Graham A. Johnston, M.R.C.P.

N Engl J Med 2006; 354:e10March 16, 2006

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Article

A 90-year-old woman presented with a one-month history of a rapidly enlarging cystic lesion on the flexor aspect of her left fifth finger. The lesion was tender and caused impairment of function. A clinical diagnosis of a ganglion cyst arising from the flexor tendon sheath was made. The cyst was aspirated and compressed, and on review six weeks later, there was no evidence of recurrence.

Ganglia are cystic swellings that most commonly occur on the dorsal aspect of the wrist, although they can occur at other sites. In most cases, they are attached to a tendon sheath or joint capsule. They are usually asymptomatic; however, they can cause symptoms when they impinge on blood vessels, tendons, or nerves. Depending on the site and size of the lesions, they may cause variable impairment of function.

Neil J. Mortimer, M.R.C.P.
Graham A. Johnston, M.R.C.P.
University Hospitals of Leicester National Health Service Trust, Leicester LE1 5WW, United Kingdom