Can Multiple Ganglion Cysts Appear on the Same Spot?

Ganglion cyst

Hello, doctor! I would like to ask if it is possible to have two ganglion cysts in the same location on the back of the hand? My mother has developed a cyst (as we can see with the naked eye) on the back of her hand.
Last week, she went to a clinic to have it aspirated and received a steroid injection, which cost her 1000 NTD.
However, when she returned home, she noticed that the area was still swollen.
We thought it was just because it was right after the procedure and would go down, but a week later, it still hadn't improved.
She went back to the same clinic for a follow-up, and the doctor mentioned that there was another cyst that had not been detected previously.
They aspirated it and gave her another steroid injection, charging her 900 NTD this time.
She went to both appointments by herself without informing us, and I find it concerning that she received two steroid injections in such a short period.
I just wanted to ask about this.
Thank you.

Shulinren, 30~39 year old female. Ask Date: 2023/03/27

Dr. Shi Guozheng reply Orthopedics

Ganglion cysts are usually treated by aspiration, and corticosteroids may not always be necessary.
Sometimes, there can be more than one ganglion cyst present.
Prior to aspiration, a fine needle aspiration can be performed to assess the cysts, allowing for the possibility of aspirating all of them in one session.

Reply Date: 2023/03/27

More Info

Multiple ganglion cysts can indeed appear in the same area, including the back of the hand. Ganglion cysts are fluid-filled sacs that often develop near joints or tendons, and they can occur in clusters. While it is not uncommon for a single cyst to develop, the presence of multiple cysts in the same location can happen, especially if there is underlying irritation or repetitive stress in that area.

In your mother's case, it seems that she initially had one cyst that was aspirated (drained) and treated with a corticosteroid injection. The fact that she later discovered another cyst in the same spot suggests that the area may be predisposed to developing these cysts, possibly due to repetitive motion or strain. Ganglion cysts can recur even after treatment, and new cysts can form in the same area.

The treatment approach for ganglion cysts can vary. Aspiration and corticosteroid injection are common methods to reduce the size of the cyst and alleviate symptoms. However, these treatments do not guarantee that the cyst will not return or that new cysts will not form. In some cases, surgical intervention may be considered if the cysts are symptomatic or if they continue to recur despite conservative management.

Regarding the corticosteroid injections, while they can help reduce inflammation and swelling, repeated injections in a short period should be approached with caution. Overuse of corticosteroids can lead to potential side effects, including skin thinning, changes in pigmentation, and weakening of the surrounding tissues. It is essential for patients to communicate openly with their healthcare providers about their treatment plans and any concerns they may have.

If your mother continues to experience issues with these cysts, it may be beneficial for her to seek a second opinion from a specialist, such as an orthopedic surgeon or a hand specialist. They can provide a more comprehensive evaluation and discuss alternative treatment options, including the possibility of surgical removal if the cysts are causing significant discomfort or functional impairment.

In summary, multiple ganglion cysts can appear in the same area, and while aspiration and corticosteroid injections are common treatments, they do not always prevent recurrence. It is crucial for patients to be informed about their treatment options and to advocate for their health, especially if they have concerns about the frequency of treatments or the effectiveness of the current management plan.

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