By Heidi Moawad, MD 

 Medically reviewed by Oluseun Olufade, MD

Abnormal growths or tumors on your hand, wrist, or finger can be caused by many different things, both benign (non-cancerous) and malignant (cancerous). Benign causes include ganglion cysts and connective tissue disorders like Dupuytrens' contracture. Cancerous causes include squamous cell carcinoma and chondrosarcoma¹

While cancer is a less common cause of a lump or bump on your hand or wrist, it will likely be investigated if the cause is unclear. This may involve imaging studies like an X-ray or ultrasound. A needle or incisional biopsy can definitively confirm or exclude cancer as the cause.¹

This article describes the signs of symptoms of cancer of the hand and lists the different types of tumors—both cancerous and non-cancerous—that can develop in the skin, cartilage, or bone. It also explains how hand tumors are diagnosed and treated.

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Is the Tumor Cancerous?

A tumor can be cancerous or non-cancerous. A tumor is simply a solid mass of tissue that forms when abnormal cells group together. Cancer occurs when the abnormal cells grow out of control and have the potential to invade other tissues and organs.

A malignant hand tumor can look very much like a benign hand tumor and be difficult for even a healthcare provider to distinguish. If cancer is involved, the appearance of the lump can differ based on whether it started in the skin, cartilage, bones, or connective tissues.

Despite the variations in appearance and/or location, there are certain clues that might suggest that a lump or bump on your hand is cancerous. As a general rule, cancerous tumors will start as painless swelling before suddenly changing and causing:

• A growing lump on the bone with deep bone pain²

• A growing lump on the skin with a rough, red, scaly surface³

• A feeling of pressure in and around the lump²

• A non-healing sore at the site of the lump³

• Pain that worsens over time³

• Increasing joint swelling, stiffness, and weakness²

The absence of these symptoms doesn't mean you should wait if a lump on your hand develops. The sudden appearance of any lump, bump, or lesion should be investigated as soon as possible.

When to See a Healthcare Provider

The most common growths on the hand and wrist are not tumors. Nodules, rashes, warts, and infections are very common, and they often require medical treatment.

Most hand and wrist tumors are benign (not harmful); they are not expected to spread to other parts of the body, and they are not damaging to your health. But there are some rare cancers of the hand and wrist, so it is important to discuss any growths with your healthcare provider, even if you are not concerned about cosmetic issues or discomfort. 

If you have a growth on your hand or wrist, you should let your healthcare provider know if you have similar growths elsewhere on your body. Your healthcare provider will also ask whether you have had any trauma to the area and whether you feel any pain, tingling, or difficulty with movement. 

Benign Tumors and Growths

It is far more likely that a lump or bump on your hand is due to a benign and treatable condition. But that doesn't mean that the growth won't cause significant pain or disability or be difficult to treat.

Depending on your condition, you may need to see a specialist in bone and joint diseases known as an orthopedic surgeon.

Ganglion Cyst

A ganglion cyst is the most common type of hand and wrist tumor. It is estimated that 10% to 30% of adults will develop a ganglion cyst at some point in their lives, most commonly between the ages of 20 and 40. It affects women approximately three times as often as men, and it rarely occurs in children. 

Generally, a ganglion cyst is a non-painful growth on a joint of the hand or wrist. Depending on its location, it can cause pain or limited movement in some instances. It is usually round, without discoloration, and about 1 to 3 centimeters in size. It may feel soft, but it is not mushy, and it can’t be moved around. A ganglion cyst is generally not tender to touch. 

Often, this type of cyst occurs in the dominant hand (the one you use to write) and there may be an association with overuse. It is filled with fluid and can appear on the outside of your hand or wrist, or on your fingers. It may grow or shrink in size. If it keeps growing, it may eventually interfere with your movement. 

You can use ice packs to relieve mild pain, and you can take oral (by mouth) anti-inflammatories if necessary.

Ganglion cysts may go away on their own. Your healthcare provider may examine your cyst with an X-ray or a magnetic resonance imaging scan (MRI), especially if planning surgical treatment. Sometimes, aspiration is used to remove the fluid inside the cyst with a needle. In some instances, surgical removal is needed.

Ganglion cysts have a tendency to return after treatment, and surgical resection is generally longer lasting than aspiration.

Giant Cell Tumors

Tenosynovial giant cell tumors and pigmented villonodular synovitis (PVNS) are similar tumors, but PVNS is more aggressive. They have a similar microscopic appearance, with the presence of a type of cell called a giant cell.

Tenosynovial giant cell tumors are benign, growing on joints in the hands, arms, or legs. They are the second most common tumors of the hand. They are also called giant cell tumors of the tendon sheath or fibrous histiocytoma of the tendon sheath.

PVNS is also called diffuse-type giant cell tumor. PVNS is more likely to affect an entire joint and cause symptoms such as limited movement but is generally found in larger joints. By contrast, tenosynovial giant cell tumors are more commonly found in small joints, such as the hand and fingers.

Treatment depends on many factors including your symptoms, the type and size of the tumor, and whether there is any concern about malignancy.

Dupuytren's Contracture

Dupuytren’s contracture is the thickening of the connective tissue in the hand, often causing a lump or an uncomfortable contracture (permanent bending) of the finger. You may have a thick knot under your skin, and it most commonly occurs between the palm and the ring finger or pinky finger.

Dupuytren’s contracture makes it difficult to move your hand and straighten your fingers.

This condition is diagnosed based on the appearance of the hand, and it tends to worsen over time. It is more common among older men and there is an association with smoking. It is usually treated with a combination of non-steroidal anti-inflammatory medication (NSAIDs), injections, splints, and physical therapy. In severe cases, surgical treatment may be recommended.

Epidermal Inclusion Cysts

Epidermal inclusion cysts are growths under the skin. They are very common growths and can appear anywhere on the body, including the hands and wrists. 

Epidermal inclusion cysts are usually firm, painless, and skin-colored. They are filled with keratin, a protein that is normally present in the skin.

This type of growth is harmless, but you can have it removed if it bothers you or causes pain or discomfort. 

Carpal Boss

Carpal boss is an overgrowth of the bones near the wrist at the base of the index or middle finger. It can manifest as a hard bump on the back of your hand. 

This is a benign growth that usually doesn’t produce symptoms besides the visible bony bump. However, it can trigger discomfort in some cases with repetitive motion or by irritating the surrounding soft tissue.

If you have problems due to this bony growth, you may need a splint, oral anti-inflammatories, or an injection. In persistent cases, surgical removal is an option if it causes severe pain or limitation of movement.

Enchondroma

A benign cartilaginous tumor called an enchondroma can appear in any bone, including your fingers. Your healthcare provider may diagnose it based on its appearance or with an imaging test, such as an X-ray or bone scan. 

Enchondromas can grow inside the bone. Most of the time, they aren’t symptomatic at all and may be discovered incidentally when you have an imaging test for another reason. 

These tumors rarely become malignant, and if you don’t have any discomfort or signs of cancer, your healthcare provider may recommend observing it periodically. 

Malignant Tumors

Malignant tumors of the hands are relatively rare. Studies suggest that around 2.5% of skin cancers occur in the hand region.⁴ The cancers most often affect the bones, cartilage, skin, and joints of the hands, fingers, or wrists.

Chondrosarcoma

Chondrosarcoma is the second most common cause of primary bone cancer and the most common cause of cancer of the hand. It starts in the cartilage-producing cells of the bones and tends to grow aggressively. Adults over 60 are most commonly affected.²

Chondrosarcomas most often affects the pinkie but can develop on any finger. As the tumor grows inside the bone, it causes a gradual bulging mass along with extreme swelling, joint stiffness, and bone pain.²

The nodule itself tends to be symmetrical with smooth (rather than rough) skin. Surgery is the most common course of treatment accompanied by chemotherapy. Radiation may be used when surgery is not an option.²

How Common Is Finger Cancer?

Chondrosarcoma is rare, affecting only one of every 200,000 people in the United States each year.⁵

Another type of cancer called subungual melanoma also affects the finger and accounts for less than 4% of skin melanomas. The cancer develops in the skin of the nail bed, causing nail cracking, pitting, bleeding, and a greenish-blue discoloration.⁶

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is the second most common type of skin cancer and the most common cancer affecting the hands. Around 90% of cases are due to excessive ultraviolet (UV) exposure from the sun or tanning beds.⁷

SCC starts with a precancerous lesion called actinic keratosis (also known as solar keratosis). The lesion gradually hardens, darkens, and grows into a wart-like mass that can bleed, ooze, and crust over.³

SCC lesions can be treated in the early stages with freezing, electricity, lasers, or photodynamic light therapy. When a large lump develops, surgery with radiation is more often pursued.³

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common type of skin cancer. Like SCC, it is largely associated with excessive UV exposure and mostly develops on sun-exposed areas of the skin. The tumor appears as a painless raised area of skin, often shiny with tiny spider veins running through it. In some cases, the bump will turn into an open, oozing sore (ulcer).⁸

There are several types of BCC, the most common of which is nodular BCC.⁸ Nodular BCC most often affects the face and neck, but can also affect the back of the hands. When it does, the tumor will often look like a raised area of scaly skin and lack the shiny, venous appearance seen on the face.⁹

Basal cell carcinoma is more common among fair-skinned people with a family history of BCC. Surgery to remove the tumor and a surrounding margin of skin is thought to be the most effective treatment.⁸

Synovial Sarcoma

Synovial sarcoma is a rare form of cancer that affects the soft tissues surrounding joints (called the synovium). It is most common in larger joints such as the knee but can also be found in the arm, leg, foot, ankle, or wrist.¹⁰

Around one-third of people with synovial sarcoma are diagnosed under the age of 30. The cancer is exceptionally rare, only affecting one to two people out of a million each year.¹⁰

Synovial sarcoma is often first noticed as a painless lump near a joint. If it is situated near a nerve, it can cause pain or numbness as the tumor grows and compresses the nerve.¹⁰

Surgery is the main treatment for synovial sarcoma followed by radiation to kill any remaining cancer cells.¹⁰

Melanoma

Melanoma is the most dangerous skin cancer that arises from pigment-producing skin cells called melanocytes. Excessive UV light exposure is the main risk factor, particularly in light-skinned people.¹¹

Melanoma often starts in existing moles that suddenly change in size, shape, and color—typically becoming asymmetrical and multi-colored with irregular edges. There is also a type called nodular melanoma which causes a new, dome-shaped lump on the skin that may be dark brown, tan, multi-colored, or skin-colored.¹¹

When the hand is affected, melanoma will most commonly occur on the back of the hand, the tip of a finger, or the nail bed (subungual melanoma). Less commonly, a tumor may appear on the palm.¹²

Because the skin on the back of the hand is thinner, melanoma is more likely to spread to distant organs (metastasize) than tumors found on other parts of the body.¹²

Surgery is needed to remove a tumor, Metastatic melanoma may also be treated with biologic immunotherapies like Keytruda (pembrolizumab) and Opdivo (nivolumab).¹³

Diagnosis

Your healthcare provider will examine your sensation and motor strength to determine whether you have any nerve impairment. Your blood flow will be evaluated based on your pulse and the color of your hands and fingers (if they are pale or bluish, you may have impaired blood flow).

You may need to have an imaging examination. Most of the time, an X-ray can identify whether your growth is fluid-filled, or whether it is composed of bone, cartilage, or soft tissue. If you need further imaging, bone scans and magnetic resonance imaging (MRI) tests are often used to visualize these types of tumors. 

If there is any concern about malignancy, you may need to have a biopsy of your tumor. A biopsy involves a surgical sample or a needle aspiration if the tumor is fluid-filled. The sample is examined under a microscope so that its pathological characteristics can be closely studied—this examination can identify whether the tumor is benign or malignant and what type of tumor it is. 

Treatment

The treatment of tumors of the hand, wrist, or finger can differ by the cause. Some conditions will resolve on their own, while others may require aggressive treatment.

Treatment options include:

• Ice application: Used to reduce inflammation and joint pain

• Heat application: Used to ease joint stiffness and increase blood circulation

• Splinting: Used during recovery to support the joint and aid with healing

• Nonsteroidal anti-inflammatory drugs: Eases joint swelling and pain with over-the-counter pain relievers like Advil (ibuprofen) or Aleve (naproxen)

• Aspiration: The removal of liquid from a cyst or joint space using a needle and syringe¹⁴

• Steroid injection: Delivered into a joint to reduce inflammation and pain caused by conditions like Dupuytren's contracture or carpal boss

• Collagenase injection: Delivered into connective tissues to break up hardened scars, such as occurs with Dupuytren's contracture¹⁵

• Surgery: Includes excision surgery to remove a mass (like a ganglion cyst) or Mohs surgery to gradually remove skin layers until no cancer cells remain¹⁶

• Chemotherapy: Often used after hand surgery to ensure all cancer cells are killed

• Radiation: Used to treat certain cancers as well as to reduce benign growths such as giant cell tumors¹⁷

Recovery After Hand and Wrist Surgery

Sometimes, after hand surgery, nerves, muscles, or blood vessels may be impaired. This is more likely if you have a malignant tumor that infiltrated these structures because your surgeon will attempt to remove all harmful portions of the tumor— even if it means potentially affecting healthy structures. 

After any type of hand surgery, you should anticipate rehabilitation and physical therapy as you work to regain as much strength, coordination, and function in your hand and wrist as possible. 

Summary

There are benign and malignant causes of tumors of the hands, joints, and fingers. While some conditions like a ganglion cyst or Dupuytren's contracture can be diagnosed with a physical exam, medical imaging may be needed to confirm the results.

Cancer is a less likely cause of a hand tumor but one that is suspected if a lump suddenly develops and causes deep bone pain or a crusty, wart-like growth. Examples include chondrosarcoma, squamous cell sarcoma, or synovial sarcoma. A biopsy can provide definitive evidence of cancer.

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Cancer Research (UK). Melanoma skin cancer: stages and types.

Turner JB, Rinker B. Melanoma of the hand: current practice and new frontiers. Healthcare (Basel). 2014 Mar;2(1):125–138. doi:10.3390/healthcare2010125

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Additional Reading

Cavit A, Özcanli H, Sançmiş M, Ocak GA, Gürer Eİ. Tumorous conditions of the hand: A retrospective review of 402 cases. Turk Patoloji Derg. 2018;34(1):66-72. doi:10.5146/tjpath.2017.01413.

Mathoulin C, Gras M. Arthroscopic management of dorsal and volar wrist ganglion. Hand Clin. 2017 Nov;33(4):769-777. doi:10.1016/j.hcl.2017.07.012.

Zhang A, Falkowski AL, Jacobson JA, Kim SM, Koh SH, Gaetke-Udager K. Sonography of wrist ganglion cysts; Which location is most common? J Ultrasound Med. 2018 Dec 28. doi:10.1002/jum.14912. [Epub ahead of print]

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.