Differential Diagnosis for a Cyst on Top of Hand

• Single Most Likely Diagnosis
  • Ganglion cyst: This is the most common type of lump found on the hand, particularly on the wrist or the top of the hand. It is a benign, fluid-filled cyst that usually develops on the tendons or joints.
• Other Likely Diagnoses
  • Epidermoid cyst: A benign cyst that can occur anywhere on the skin, including the top of the hand, often resulting from a blocked oil gland or hair follicle.
  • Sebaceous cyst: Similar to epidermoid cysts, these are benign, usually filled with a cheesy, semi-solid material, and can occur on the hand.
  • Lipoma: A benign tumor composed of fat tissue, which can appear as a soft, movable lump under the skin on various parts of the body, including the hand.
• Do Not Miss Diagnoses
  • Glomus tumor: Although rare, this benign tumor of the glomus body (a part of the dermal layer that regulates temperature) can be painful and typically occurs under the fingernail but can also appear on the top of the hand. Missing this diagnosis could lead to unnecessary prolonged pain.
  • Squamous cell carcinoma or other skin cancers: While less common, any new lump or cyst, especially in sun-exposed areas like the top of the hand, should be evaluated for the possibility of skin cancer to ensure early detection and treatment.
• Rare Diagnoses
  • Dermatofibroma: A rare, benign growth that can appear as a firm, round, brownish to purple growth, often resulting from minor injury, most commonly on the legs but can occur on the hand.
  • Osteochondroma (if the cyst is near a joint and involves bone): A type of benign bone tumor that can occur near the ends of bones, potentially causing a visible lump if it grows near the surface, such as on the hand near a joint.