I scrubbed into a surgery involving a lesion that looked pretty much like the one shown above. This appeared in a 40 year old female secretary after she applied lotion to her wrists and felt a pop. The lump was initially soft and painless, but over the last few months, it has grown in size, become harder, and caused a little discomfort. The mass transilluminates.Challenge: What is the most likely diagnosis?
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lipoma
Touch of God
This is most likely a ganglion cyst, a cystic swelling overlying a joint or tendon sheath thought to arise from the herniation of synovial tissue. The lesions can be caused by trauma or congenital and are worsened by repetitive movements. Common locations include the wrist and tissue adjacent to the finger joints. Aspiration of the cysts gives jelly-like synovial fluid. They are also known as a Bible bump as one old treatment for the cysts was to smash it with a Bible (though recurrences would be likely).
Source: Wikipedia.
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