A painless lump on the dorsum of the wrist that recurs is most consistent with which diagnosis?

• A. Lipoma
• B. Cystic Lesion
• C. Ganglion Cyst
• D. Epidermoid Cyst

Answer: (C)

A lump on the dorsum of the wrist that is painless and tends to come back after treatment is most characteristic of a ganglion cyst. These cysts arise from a joint capsule or tendon sheath and fill with a thick, jelly-like fluid. They’re often located on the dorsum of the wrist, may be smooth and mobile, and can wax and wane in size. A hallmark is their tendency to recur after aspiration or incomplete excision, because the stalk connecting to the joint or tendon sheath can persist. Lipomas are usually soft, subcutaneous, and occur in other locations rather than the classic dorsal wrist site; epidermoid cysts often have a central punctum and are less typical for a recurrent dorsal wrist mass. A generic “cystic lesion” is less specific than identifying a ganglion cyst, which best fits the common clinical pattern here.