High School

A 29-year-old female presents with a "bump" on her wrist for the past week. She denies any pain or history of trauma. Her past medical history is unremarkable. On physical examination, you discover a 2.0 cm nontender, firm cystic lesion on the dorsum of the wrist. What is the most likely diagnosis?

A. Squamous cell carcinoma
B. De Quervain tenosynovitis
C. Osteosarcoma
D. Ganglion cyst
E. Gout

Answer :

Final answer:

The most likely diagnosis for the patient's wrist condition is D. Ganglion cyst, which is a benign, fluid-filled lump commonly found on the wrist and is often asymptomatic unless it grows large or is in a bothersome location, so the correct option is (d).

Explanation:

The most likely diagnosis for a 29-year-old female presenting with a non-tender, firm cystic lesion on the dorsum of the wrist is D. Ganglion cyst. A ganglion cyst is a common, benign, fluid-filled lump that often appears along the tendons or joints of your wrists or hands. The cysts can be of various sizes and might grow larger with increased wrist activity. With the patient denying pain or a history of trauma and the physical examination findings, this condition fits the presentation more closely than the other options.

Squamous cell carcinoma is less likely without a history of significant sun exposure or indicative lesions. De Quervain tenosynovitis typically presents with pain and tenderness, which is not evidenced in this case. Osteosarcoma would be highly unusual in this location and presentation, especially without pain. Lastly, gout usually presents with pain and is associated with joint inflammation. In summary, the nontender, firm cystic lesion on the wrist is quite characteristic of a ganglion cyst, which is a benign condition often requiring no treatment, although aspiration or removal can be performed if the cyst is bothersome.