A 46-year-old woman presents with wrist pain and a jelly-like bump on the dorsum of the wrist. What is the most likely diagnosis?

• A. Cancerous tumor
• B. Fracture
• C. Ganglion cyst
• D. Hematoma

Answer: (C)

A soft, jelly-like lump on the dorsum of the wrist in an adult is most characteristic of a ganglion cyst. These arise from a joint or tendon sheath and are filled with a gelatinous mucinous fluid, giving them a doughy, fluctuant feel and often the ability to transilluminate. The dorsal wrist is the commonest site for these cysts, and they may come and go with wrist activity, sometimes causing discomfort with pressure or movement.

Cancerous tumors tend to be solid and fixed rather than fluid-filled and fluctuant. Fractures present with acute trauma, significant tenderness, deformity, and impaired function rather than a soft cystic mass. Hematomas follow an injury and are usually bruised, tender, and firm rather than a smooth, jelly-like cystic lump.