Ganglion Cyst in Children: Reviewing Treatment and Recurrence Rates

Abstract

BACKGROUND Pediatric hand and wrist ganglia seem to have different epidemiological characteristics than those of adults – a majority are found on the volar aspect of the hands and wrists of patients younger than 10 years of age. OBJECTIVE To determine the epidemiology, etiological factors, clinical presentation, treatment and outcome of patients with ganglion cysts at the Hospital for Sick Children (Toronto, Ontario). METHODS The records of the pathology department at the Hospital for Sick Children were searched for all cases of ganglion cyst operated on between January 2000 and December 2008. RESULTS Thirty-seven patients underwent treatment for symptomatic ganglion cyst. The mean age of the patients was 9.6 years, and there were 23 females. A mobile nodule was the initial presentation of the ganglion in 64% of the cases. Pain was the most common indication for surgical removal. Only 11.4% of patients experienced previous trauma. In 70% of the cases, the diagnosis was made clinically. The most common sites of occurrence were volar wrist (25.7%), dorsal wrist (22.8%) and the volar aspect of the base of the ring finger (17.1%). Surgical excision was the treatment of choice for 94.2% of the patients with symptomatic lesions. The minimum follow-up period was 12 months. Only one patient (2.8%) presented with recurrence in the series. CONCLUSION Although it is possible that these findings might change with longer follow-up, the present data provide information to help guide the treatment of these cysts. Complete surgical removal is a very effective treatment, with low rates of recurrence.