Lumps and bumps on the hands and wrists are typically due to benign causes like ganglion cysts, inclusion cysts, or bone overgrowth. Rarely, they are signs of cancers of the bone, cartilage, and soft tissue. The masses may be visible and cause symptoms, or not felt or otherwise noticed at all.
When diagnosing a hand or wrist mass, a doctor will typically explore the most common causes first. These include noncancerous growths, cysts, and tumors. If an exam and imaging aren’t enough to identify one of these bumps, a sample of its tissue will be removed and examined under a microscope.
This article explains what causes lumps and bumps on the hands and wrists.
Ganglion Cysts
Ganglion cysts are considered the most likely suspect and represent the majority of all abnormal hand and wrist growths.
These bumps are caused when the lining of the small joints forms a small pouch and fluids leak into it.
Ganglion cysts can also form pouches in the sheath covering a tendon or knuckle joint. This type is called a mucous cyst.
Giant Cell Tumor of the Tendon Sheath
Giant cell tumor of tendon sheath is not a true tumor. Instead, it is a mass that arises from the sheath or lining of a tendon. It can also arise from the synovium, the soft tissue inside a joint.
Giant cell tumors of the tendon sheath tend to grow slowly. They can often become extremely painful. The problem with these masses is that they are easily removed but often come back.
Inclusion Cysts
Inclusion cysts are noncancerous growths caused by an injury to a hand or finger.
A penetrating wound, such as a deep cut, can push surface cells into the deep layers of the hand or finger.
These cells, considered foreign, are then surrounded by the immune system. They gradually expand in size over time, forming inclusion cysts.
Inclusions cysts often form years after an injury occurs.
Carpal Boss
A hard lump on your wrist that feels like bone may be a carpal boss. That’s an overgrowth of the bone on the back of the hand. It’s similar in appearance to a bone spur.
Carpal boss is essentially a small area of osteoarthritis occurring at the point where the long hand bones and small wrist bones connect.
While frequently misdiagnosed as a ganglion cyst, a carpal boss is firmer. Unlike a cyst, you cannot move it or feel any “give” when you press on it.
Enchondroma
Enchondroma is a noncancerous tumor that develops when cartilage grows inside a bone.
An enchondroma can become a problem if and when the tumor weakens the bone. This increases the risk of a pathologic fracture.
Enchondromas are mostly benign and only rarely develop into cancer.
Cancer of the Hands or Wrists
Sometimes cancer develops beneath the skin of the hand or wrist. It’s usually due to cancerous cells that have spread (metastasized) from elsewhere in the body, most often the lungs.
The hand and wrist are not common locations for cancers to spread, but it is not impossible.
Cancer seldom begins in the hands or wrists. But there are rare cases where tumors have formed in the bone or cartilage of the hand.
These cancers are called sarcomas. They represent less than 1% of all solid cancerous tumors (malignancies) in adults.
By contrast, more than 20% of all pediatric solid malignant tumors are sarcomas. They mainly develop in soft tissue, such as fat and muscle. But around 10% will occur in the bones of the hands or wrists.
It is not entirely clear what causes a sarcoma. The following are the most likely to play a part in its development:
- Family historyExposure to chemicalsRadiation
Cancers of the hands and wrist are serious problems that often require:
- Invasive treatmentProlonged care
Summary
Most of the time, masses in the hand and wrist are noncancerous. One common type of benign growth in the hand or wrist is called a ganglion cyst.
While rare, it is possible for a lump or bump in the hand or wrist to be cancerous, however. When this occurs, it’s typically because of cancer found elsewhere in the body.
It’s important to visit your doctor if you notice a mass or growth beneath your skin. After careful evaluation, they can determine if the growth is cancerous or nothing to worry about.
Frequently Asked Questions
- What is the hard lump on my wrist that feels like bone?
- A likely cause is a carpal boss, which is an overgrowth of bone on the back of your hand. Because it’s bone, it doesn’t move or feel spongy when you push on it.
- How are lumps on the hands diagnosed?
- Your healthcare provider will likely start with a physical examination and imaging studies (X-ray, CT scan). In some cases, a biopsy may be needed.
- Is a ganglion cyst hard like bone?
- No, ganglion cysts are typically not hard to the touch. They are soft, gel-like masses that are usually smooth and round. However, excess fluid can sometimes build up and create pressure inside the cyst, which makes it feel very firm.
- Do ganglion cysts hurt when pressed?
- Ganglion cysts do not contain nerves and should not hurt when pressed. However, pain, tingling, or numbness can occur if the ganglion cyst is pressed against a nerve.
- Is a cancerous lump hard or soft?
- Cancerous lumps are usually hard, but that doesn’t mean that all hard lumps are cancer. Any lump—hard or soft—should be evaluated by a healthcare provider.
A likely cause is a carpal boss, which is an overgrowth of bone on the back of your hand. Because it’s bone, it doesn’t move or feel spongy when you push on it.
Your healthcare provider will likely start with a physical examination and imaging studies (X-ray, CT scan). In some cases, a biopsy may be needed.
No, ganglion cysts are typically not hard to the touch. They are soft, gel-like masses that are usually smooth and round. However, excess fluid can sometimes build up and create pressure inside the cyst, which makes it feel very firm.
Ganglion cysts do not contain nerves and should not hurt when pressed. However, pain, tingling, or numbness can occur if the ganglion cyst is pressed against a nerve.
Cancerous lumps are usually hard, but that doesn’t mean that all hard lumps are cancer. Any lump—hard or soft—should be evaluated by a healthcare provider.
