Ganglion cysts, foreign bodies and vascular malformations are some of the most common causes of a palpable mass in the pediatric hand. There are other rare tumors such as digital fibromas, which are unique to the pediatric population. Malignant tumors in the hands of children are very rare.
Volar ganglia are more common in the hands of children less than 10 years old. A high recurrence rate (36%) following surgery was observed, putting in question the value of surgery. Thus, many are treated conservatively.
In the series by Wang et al the average age of the patient at the time of diagnosis in their series was 38 months (range, 2 months to 9 years 3 months). Cysts had been present for an average of 3.3 months (range, 1-12 months) before medical advice was sought. None of the cysts were painful. Follow-up averaged 33 months (range, 9-112 months), with 79% of all cysts spontaneously resolving, the majority within a year. These findings suggest that a child presenting with a benign hand lesion characteristic of a ganglion cyst should initially be treated by observation.