What is this weird bulge in my palm?

April 6, 2013 7:16 PM

This bulge between my thumb and forefinger appeared in November of last year. What is going on?

I noticed my hand hurt after carrying a plastic grocery bag and saw the bulge and figured I popped a vessel but it never went away. It aches off and on and sometimes looks less swollen but never gone. My doctor looked at it shortly after it happened but brushed it off and just said it would probably go away on its own. Relevant background: I knit up until I noticed this, I type a few times a week, and take handwritten notes a few times a week. Please help me solve this mystery!

posted by Kyrieleis to Health & Fitness (27 answers total)

Best answer: A Ganglion Cyst?

Had one on my wrist once for 3 years, then it disappeared.
posted by batikrose at 7:21 PM on April 6, 2013

Have you been back to the doctor?
posted by cranberry_nut at 7:21 PM on April 6, 2013 [1 favorite]

Response by poster: I apologize for not knowing how to add a link. Here's a photo:

www.flickr.com/photos/94747387@N06/
posted by Kyrieleis at 7:22 PM on April 6, 2013

Not sure it looks like a ganglion cyst from the picture, but IANAD ... I'd ask doctor about it again, especially if it is bothering you. Do look at the above posted link though ... for ideas.
posted by batikrose at 7:26 PM on April 6, 2013

AKA Bible Cyst (in the old days, whack it with a bible to break it up and make it go away)
posted by beagle at 7:28 PM on April 6, 2013

My mother and I have both had that in our hands and I've also had it on the sole of my foot. For us we had overextended a tendon and the tendon had become so inflamed that it started pushing up out of its natural position.
posted by These Birds of a Feather at 7:32 PM on April 6, 2013

Assuming your doc is right that it's a harmless cyst... I had one of those on my wrist several years ago. I tripped and fell on it one day, and it completely vanished with a sickening POP. So you have that to look forward to.
posted by mindsound at 7:32 PM on April 6, 2013 [1 favorite]

Response by poster: Could it be a cyst? It's not roundish, it's long and narrow. And it's sinewy feeling and rubbery and I feel like I can feel the tendon moving in there when my fingers move. Thanks for the help so far! I can't go back to the doctor until June.
posted by Kyrieleis at 7:33 PM on April 6, 2013

Response by poster: These Birds of a Feather--Did it go away and how long did it last?
posted by Kyrieleis at 7:35 PM on April 6, 2013

My mom had this. Doc said it's genetic and is fairly common among those of Nordic/Viking ancestry. She had it removed via outpatient surgery...

http://en.wikipedia.org/wiki/Dupuytren's_contracture
posted by matty at 7:41 PM on April 6, 2013 [2 favorites]

Yes, it went away, but it took 4-6 months. For both me and my mom (and my dad, actually; I forgot he's had this too) it was a kind of modified trigger finger issue. We each had to wrap our foot/hand securely in an ace bandage to offer the affected portion more support and stability. Advil and Tylenol helped reduced the pain we each felt. You should definitely talk with your doctor if it continues to remain visible, but maybe an ace bandage might help since you've seen no change in the issue lately.

FWIW, my mom's was the most severe looking and feeling but it didn't limit her fingers' range of mobility, whereas my dad didn't get nearly as visible a lump but his fingers basically couldn't curl past a certain point and he recently had to have surgery to fix it. My foot situation was so painful and so bizarre because it would happen over and over at random but go away after 15 min. I haven't had the issue reoccur in a while.
posted by These Birds of a Feather at 7:44 PM on April 6, 2013

It sounds more like a tendon inflamation resulting in a Trigger Finger sometimes these settle on their own (with rest and ant-inflammatories). Sometimes with a steroid injection and at the worst end of the spectrum a simple surgical procedure.

If this is indeed what it is, leaving it alone won't cause you any harm.

Depending on how much it is impacting on you (pain and function) will determine how far you want to push the treatment.
posted by mule at 7:46 PM on April 6, 2013

Best answer: Hand doctor here, not yours, etc (standard disclaimers) but I have never seen a ganglion in that location. I also have never seen a trigger finger that causes visible and palpable swelling like your picture shows. My money would be on a giant cell tumor of the tendon sheath but the only way to know for sure would be to get it removed. If you were my patient, I would recommend surgery. Let us know what it is. BTW, malignancy in the hand is exceedingly rare, especially in young people, in case that is weighing on you, but regardless, it should come out. Also, not Dupuytren's, unless it's the worst case ever reported.
posted by karlos at 8:03 PM on April 6, 2013 [1 favorite]

Response by poster: Oh my god...tumor? This thing is a long, narrow bulge about 1.25 inch long and a quarter inch wide and not bumpy at all but smooth feeling. Do tumors grow like that? Now I'm a little freaked out.
posted by Kyrieleis at 8:11 PM on April 6, 2013

Doctor.
Best idea here.

FWIW, I had something that looked very much like that when a horse yanked a rope through my hand, and I refused to let go. Stupid, yes. Hurt like a bugger for weeks, didn't go down for several months, but all gone within 6 mos.

But you have the recommendation of a hand doctor to see a professional right here in your post. Why would you listen to a bunch of AskMe hand-wavers?
posted by BlueHorse at 8:56 PM on April 6, 2013 [2 favorites]

You might find it helpful to read more about that type of tumor (the source is a little technical but I think it has a lot of good information).

Giant cell tumors of the tendon sheath are benign, so, if that is what it is, there is no need to freak out.
posted by treehorn+bunny at 8:58 PM on April 6, 2013 [1 favorite]

Best answer: Kyrieleis, I have no idea what it is, but I will highlight a point that karlos made which may have been lost in their frank and clinical assessment.

Many, many, many tumors are not malignant. Not cancerous. If you have a tumor - and it is a super big if - it is probably a benign growth - a benign tumor. I know the word tumor can start hyperventilation in the non-medically trained (such as myself). So please, please be kind to yourself, and before you freak yourself out (anymore), get yourself to a health professional who can see you and do a little checking and help you figure out what the best next step is for you.

Once again, I say this not as a medically trained person, but as a person married to a medically trained person who has foolishly used them way to many times for an off the cuff medical diagnosis and then realized that because they thought I understood and put proper weight on what they were saying, 'BTW, malignancy in the hand is exceedingly rare. etc.', they couldn't understand why I was freaking out. (Because I had stopped registering their words after the word 'tumor' and started imagining all sorts of things).
posted by anitanita at 9:00 PM on April 6, 2013 [2 favorites]

I've had three different hand tumors, all benign and all spread out over about ten years. One which was on a tendon was cured by a shot of cortisone, one which was in my finger bone required surgery and a cadaver graft, and the third is still in my hand since the doctor who removed the second assessed it and said to wait on that one.
posted by vegartanipla at 9:10 PM on April 6, 2013

Oh, and FYI go to an orthopedic hand specialist surgeon for assessment. They'll have seen it all.
posted by vegartanipla at 9:12 PM on April 6, 2013

Response by poster: Thank you to everyone who posted. I was thinking it was probably an inflamed tendon of some kind and I wasn't expecting anything even relatively serious so I'm a little shocked. I don't really know when I can get to a hand specialist, but that seems to be the consensus.

I did note in my question that it seems to decrease when I have rested my hand. There is a visible tendon on the other hand, too, that is raised but a lot less so. I don't know if that info makes a difference or not.
posted by Kyrieleis at 9:23 PM on April 6, 2013

Response by poster: The other hand.
posted by Kyrieleis at 9:27 PM on April 6, 2013

Well, you know my third tumor that hasn't been removed yet? It's in basically the same location, on the opposite hand, as the second one. Problems can be bilaterally symmetrical just like features. Check with the specialist.
posted by vegartanipla at 9:35 PM on April 6, 2013

I don't know what it is but here is some very important advice re hand surgery. when they ask you if you prefer a general anesthetic, sedation plus a local or just a local do not choose "just a local". Agreeing to have local anesthetic injected into the palm of my hand while totally conscious was one of the dumber things I've ever done.
posted by fshgrl at 9:50 PM on April 6, 2013

Response by poster: Update: I got worried today and saw a doctor at the minor med. She said she thinks it's a ganglion cyst. She referred me to an orthopedic doctor for confirmation and treatment. Thanks everyone!
posted by Kyrieleis at 10:31 AM on April 7, 2013 [1 favorite]

Considering you've had the lump for 5 months, the doctor at urgent care was probably surprised to see you today...

I'm not sure if you had time to read my answer noting that the giant cell tumor is benign. Here's the first sentence from the link I included: "Giant cell tumors of the tendon sheath are the second most common tumors of the hand, with simple ganglion cysts being the most common."
posted by treehorn+bunny at 10:58 AM on April 7, 2013

In other words, no one in this thread suggested that it was anything even 'relatively serious' - but I'm glad you got reassurance.
posted by treehorn+bunny at 10:59 AM on April 7, 2013

Response by poster: treehorn + bunny--thanks for your input. I went for reassurance and I got it. I wasn't trying to imply at any point that anyone's answers here caused me to completely panic, but they did cause me to realize that this thing probably isn't going away on it's own and I should go ahead and be seen and initiate the referral process. It was an off hours clinic, not an emergency clinic. Most people were there for a cold and I don't think my presence was too shocking.
posted by Kyrieleis at 11:10 AM on April 7, 2013