Carpal Tunnel Syndrome Caused by a Ganglion Cyst of the Wrist: Report of a Case and Review of Literature

Abstract

Carpal tunnel syndrome is usually idiopathic and presents bilaterally. An etiologic factor should be suspected in patients with unilateral symptoms, Ganglion cysts are the most common tumours of the wrist and are often listed among the possible causes of carpal tunnel syndrome but cases of carpal tunnel syndrome caused by ganglion cysts are underreported in literature. The clinical presentation consists of swelling and pain of the wrist with paresthesia in the median nerve distribution. Tinel’s sign and Phalen’s manoeuvre are positive. Electromyogram (EMG) should be accompanied by ultrasonography or magnetic resonance imaging (MRI) investigation before surgery. Although the current trend is to perform endoscopic carpal tunnel release, this technique can’t allow a good exploration of the carpal tunnel, and open carpal tunnel release surgery with removal of the ganglion cyst remains the gold standard of treatment with an excellent prognosis. We present the case of a 45-year-old woman with carpal tunnel syndrome caused by a ganglion cyst to highlight its characteristics, the interest of imaging studies (ultrasonography or MRI) in patients with unilateral symptoms, and the importance of early recognition with adequate treatment.