G anglion cysts are mucinous tumours that usually arise from underlying joint capsules or tendon sheaths, and are the most common soft tissue masses of the hand (1). Their pathogenesis remains controversial. The extracapsular part of the dorsal ganglia is well known, but little is known about the intracapsular component and its etiology. While a great deal of information exists for adult hand and wrist ganglia, there is a paucity of data for the pediatric population. Although they commonly occur as benign lesions in adults, ganglia of the hand and wrist are much less common in children. The exact incidence is uncertain, but Nelson et al (1) reported on a series of 543 hand and wrist ganglia. Approximately 10% occurred in patients younger than 20 years of age, and less than 2% were in patients younger than 10 years of age. However, the incidence of ganglia in children is probably underestimated because their presence is usually painless and does not interfere with function; therefore, they may not be brought to the attention of a physician.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 hand and wrist in patients younger than 10 years of age (2).Studies regarding the treatment of hand ganglia in children have generally shown increased rates of recurrence with aspiration or surgery when compared with adults who have undergone similar treatment. Recurrence rates of up to 43% with various puncture techniques (3), including aspiration, and 35% following surgical excision have been reported (2). Only a few studies have examined the treatment of pediatric ganglia through observation: MacCollum (4) found a 64% spontaneous resolution rate in a series that included only dorsal wrist ganglia (gathered from several centres), and Rosson and Walker (5), whose study included patients 15 years of age or younger, reported a 76% resolution rate in a series that included foot ganglia.The objectives of the present study were to determine the most common sites of pediatric ganglia occurrence and the most effective method of treatment. patients and MethodsThe records of the pathology department at The Hospital for Sick Children (Toronto, Ontario) were retrospectively searched for all cases of ganglion cyst surgically treated between January 2000 and oRiGinal aRticle ©2011 Pulsus Group Inc. All rights reserved 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 pat...
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.
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