Ganglion cyst in children: Reviewing treatment and recurrence rates.

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.