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Recurrence of Ganglion Cysts Following Re-excision
Lindsay McAlpine, BS; Juana Medina, MD; Nayoung Kim, BS; Michael Rivlin, MD
Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA

Introduction: The recurrence of ganglion cysts after surgical excision has a reported rate of 4% to 40%. However, recurrence after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts in patients who underwent secondary excision procedure.
Materials & Methods: With Institutional Review Board approval, we retrospectively identified by Current Procedural Terminology (CPT) code and reviewed charts of patients who had recurrent ganglion cyst excision. Recurrence was defined as reappearance of a cyst in the same area as prior. Patients were interviewed via phone or email. Demographics, recurrence, 3rd revision surgery and other variables were collected along with outcome variables such as patient satisfaction, pain levels, and functional limitations.
Results: Of the 44 revision cases identified 15 patients were reached. Time to recurrence of the cyst after the first ganglion cyst excision ranged from 1 month to 13 years with an average of 3.3 years. After the second ganglion cyst excision only 2 patients (13%, both volar) had a recurrence. The time to recurrence was 9 and 12 months.. One of the two patients underwent a third ganglion cyst excision successfully after reporting difficulty with day to day activities due to the cyst. The other patient declined surgical intervention and had no pain. Patients without a second recurrence (n=13) reported an average pain score of 0.2 ranging from 0-2 on a scale of 1-10. Two (15%) reported some difficulty with day to day activities due to the scar. Four patients (27%) reported other symptoms related to the scar and six patients (40%) reported at least transient numbness or tingling.. Patients reported an average satisfaction of 9.5 on a scale of 1-10.All patients would undergo another ganglion cyst excision should they have another recurrence.
Conclusions: Patients should be advised about the risk of recurrence after re-excision of ganglion cysts. Even though the incidence is similar to the recurrence of primarily excised cysts, all patients would undergo the procedure again if the cyst recurred.

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