What Are These Lumps in the Palm of My Hand?

Symptoms of lumps in the palm of the hand can vary depending on the cause. 

Symptoms of a lump in the palm of the hand caused by a ganglion cyst may include: 

• A visible lump (though smaller ganglions can be hidden under the skin)
• Pain
• Tingling
• Muscle weakness

Symptoms of a lump in the palm of the hand caused by Dupuytren’s nodule may affect one or both hands and include:

• Thickening of the tissue under the skin on the palm of the hand (usually painless)
• Hard bumps (nodules) under the skin on the palm
• Bands (cords) of thick tissue under the skin on the palm
• Finger joint stiffness
• Difficulty straightening one or more fingers all the way (usually the ring and little fingers)
• Pits within the palm

Symptoms of a lump in the palm of the hand caused by a giant cell tumor may include:

• A visible mass
• Swelling
• Pain at the nearest joint
• Fluid buildup in the joint nearest the affected bone
• Limited movement in the nearest joint
• Bone fracture

Symptoms of a lump in the palm of the hand caused by an epidermal inclusion cyst may include:

• A lump just beneath the skin
• Pain
• A foul odor of the cyst
• Inflammation of the cyst
• Redness of the cyst
• Leaking fluid or thick material from the cyst

Symptoms of a lump in the palm of the hand caused by a lipoma may include:

• A roundish mass that feels soft and rubbery
• Those just under the skin can be moved with gentle pushing
• Generally, not painful though some types may hurt

Symptoms of a lump in the palm of the hand caused by nerve tumors may include:

• A bump or clusters of bumps and nodules on or just under the skin with well-defined borders
• May be soft or firm
• May cause pain
• Muscle weakness
• Numbness or tingling
• Deformity 
• Loss of function

Symptoms of a lump in the palm of the hand caused by a neuroma may include:

• A well-defined hard lump 
• Inflammation
• Burning or sharp pain 
• Tingling sensation
• Numbness

The cause of lumps in the palm of the hand depends on the condition. 

• Ganglion cyst
  • It is not known what triggers a ganglion cyst
  • Ganglion cysts that develop at the end joint on the nail side of a finger are often associated with arthritis in the finger joint
• Dupuytren’s nodule
  • The cause of Dupuytren's disease is not completely known, though it is believed genetics plays an important role
  • Risk factors believed to contribute to the development or worsening of Dupuytren's disease include:
    • Being male
    • Age over 40 years
    • Ethnicity: People of northern European (English, Irish, Scottish, French, and Dutch) and Scandinavian (Swedish, Norwegian, and Finnish) ancestry are more likely to develop the condition
    • Family history of the condition
    • Heavy alcohol consumption
    • Smoking
    • Previous injury to the hand
    • Certain medical conditions
    • Use of certain medications 
• Giant cell tumor of the tendon sheath
  • The cause of giant cell tumors is unknown
• Epidermal inclusion cyst
  • Usually caused by skin (epidermal) cells moving under the skin surface, or being covered over by it instead of shedding and continuing to multiply
  • Often occurs due to a skin injury
• Lipomas
  • The cause is not completely understood
  • Some subtypes may have a genetic component and may be inherited from family members
• Nerve tumors
  • Neurofibromas usually occur in association with a genetic disorder called neurofibromatosis type 1 (NF1)
• Neuromas
  • Occurs after a nerve is partially or completely injured, such as a cut, a crush, an excessive stretch, or even after surgery or amputation

Lumps in the palm of the hand are diagnosed with a patient history and physical examination of the hand. Pressure may be applied to the lumps to test for tenderness or discomfort. 

Tests used to help diagnose the cause of a lump in the palm of the hand may include: 

• Imaging tests
  • X-ray
  • Magnetic resonance imaging (MRI) scan
  • Computerized tomography (CT) scan
  • Ultrasound 
  • Radionuclide bone scan
  • Positron emission tomography (PET) scan
• Biopsy

Treatment for lumps in the palm of the hand depends on the cause. 

Treatment for a ganglion cyst may include: 

• Observation
  • Waiting and watching to make sure no unusual changes occur 
  • Ganglions are not cancerous and may go away on their own 
• Immobilization
  • A wrist brace or splint to relieve symptoms 
• Exercises to strengthen the wrist and improve range of motion
• Draining fluid from the cyst (aspiration) if it causes pain or limits activity
• Surgery to remove the cyst (excision)

Treatment for Dupuytren’s nodule varies depending on the severity of the symptoms. 

• In mild cases, medical treatment may not be needed. Home remedies to manage symptoms of a Dupuytren’s nodule include:
  • Hand exercises to keep fingers flexible and maintain hand function
  • Modifying tools by cushioning handles or using padded gloves to help with grasping 
  • Massage to help relieve pain

Treatment for serious cases of Dupuytren's contracture includes: 

• Radiation
• A needle stuck into the palm to break apart the thick tissue (needle aponeurotomy)
• Collagenase injection (Xiapex) is injected into the palm can help soften and break up thick tissue
• Surgery to remove or break apart thick tissue.

Treatment for a giant cell tumor is based on the severity of the disease and the patient’s overall health and may include: 

• Radiation therapy
• Surgery to remove the tumor 
• Physical therapy to regain strength and mobility
• Amputation, in severe cases

Epidermal inclusion cysts often go away on their own and do not need treatment. When treatment is needed for an epidermal inclusion cyst, it may include surgery (excision) with removal of the cyst and cyst wall.  

Treatment for lipomas may include:

• Observation
  • No treatment may be needed because lipomas are benign but they may be monitored for changes
• Removal of the lipoma (excision)

Treatment for nerve tumors can vary widely, depending on the type and severity of the tumor, the tumor’s location, and the patient’s overall health. Treatment for nerve tumors may include: 

• Monitoring small benign tumors for changes
• Tumor removal surgery
• Radiation therapy
• Chemotherapy
• Rehabilitation to recover from surgery

Treatment for neuromas can vary and may include: 

• Conservative methods such as ice packs, elevation, and rest to reduce swelling
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation
• Local anesthetic creams or injections
• Steroid injections
• Surgical excision, though recurrence rates are high