Abstract
Purpose of study:
“Ganglia are a benign condition taking up the time of competent surgeons who might be more usefully engaged.” – McEvedy
Our aim was to perform a retrospective review comparing preoperative clinical presentation, intraoperative findings and histological diagnosis of all hand and wrist ganglia presenting to the Hand Unit at Chris Hani Baragwanath Hospital.
Methods:
A retrospective review of hand and wrist ganglia treated at the Hand Unit at Chris Hani Baragwanath Hospital. Clinical and surgical notes and histology reports were reviewed. All ganglia were removed surgically as directed by clinical findings.
Results:
A total of 75 hand and wrist masses were operated over a period of 6 months between January and June 2012. Of these 42 were clinically diagnosed as ganglia. All 42 “ganglia” were removed surgically and sent for histological evaluation. Of these, 40 were diagnosed intra-operatively as ganglia. In 2 cases the diagnoses were changed intra-operatively to synovitis and Giant Cell Tumor of tendon sheath. Histologically 5 out of 42 cases were found not to be ganglia; their diagnoses were as follows:
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1.
Granulomatous synovitis
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2.
Chronic inflammation (possible tuberculous)
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3.
Giant Cell Tumour of Tendon Sheath. (Correlates with intra-op diagnosis)
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4.
Nerve sheath tumour (Schwannoma)
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5.
Chronic bursitis.
Conclusion:
Be wary of “the simple ganglion”. Other conditions may mimic a ganglion with potentially disastrous consequence if misdiagnosed. In our setting histological evaluation is compulsory. Always follow the patient up and confirm histological diagnosis.
