Posts

Translate this page into:

Atypical Venous Malformation of the Volar Wrist Presenting as a Ganglion Cyst: Diagnostic Pitfalls and Surgical Insights – Case Report

Case Report | Journal of Clinical Orthopaedics | Vol 10 | Issue 2 | July-December 2025 | page: 119-124 | J S R G Saran, Varun Devdass, Durai Anand

DOI: https://doi.org/10.13107/jcorth.2025.v10.i02.798

Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 08 Nov 2025, Review Date: 15 Nov 2025, Accepted Date: 25 Nov 2025 & Published Date: 10 Dec 2025


Author: J S R G Saran [1], Varun Devdass [1], Durai Anand [1]

[1] Department of Orthopaedics, M S Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India


Address of Correspondence
Dr. J S R G Saran,
Department of Orthopaedics, M S Ramaiah University of Applied Sciences Nagar, Bengaluru, Karnataka 560094, India.
E-mail: jsaran868@gmail.com


Abstract


Background: Wrist swellings are most often benign cystic lesions such as ganglion cysts; however, vascular anomalies such as venous malformations (VMs), though rare, can closely mimic these entities and pose diagnostic challenges.
Case Report: A 24-year-old male presented with a painful volar wrist swelling following trauma, radiologically suggestive of a multiloculated ganglion cyst. Conservative management failed, and surgical excision through a modified Henry approach was undertaken. Intraoperatively, an ill-defined, violaceous, non-pulsatile vascular mass was identified and completely excised with assistance from a vascular surgery team. Histopathological examination confirmed a VM.
Results: Post-operative rehabilitation led to significant improvement in pain and wrist function, with no recurrence noted at short-term follow-up.
Conclusion: VMs, though rare, should be considered in persistent wrist swellings unresponsive to conservative treatment. Complete surgical excision with multidisciplinary support and structured rehabilitation can achieve excellent functional recovery and prevent recurrence.
Keywords: Atypical venous malformation, Wrist, ganglion cyst, Surgical excision, Vascular anomaly.


References


1. Cooke-Barber J, Kreimer S, Patel M, Dasgupta R, Jeng M. Venous malformations. Semin Pediatr Surg 2020;29:150976.
2. Behravesh S, Yakes W, Gupta N, Naidu S, Chong BW, Khademhosseini A, et al. Venous malformations: Clinical diagnosis and treatment. Cardiovasc Diagn Ther 2016;6:557-69.
3. Scheer HS, Banz Y, Grobbelaar AO, Vögelin E. Posttraumatic vascular anomalies in hand surgery-a case-based approach. Plast Reconstr Surg Glob Open 2021;9:e3802.
4. Tisetso Morare NM, Baloyi ER. Post-traumatic arteriovenous malformation of the superficial temporal artery. J Vasc Surg Cases Innov Tech 2020;6:50-4.
5. Ota Y, Lee E, Sella E, Agarwal P. Vascular malformations and tumors: A review of classification and imaging features for cardiothoracic radiologists. Radiol Cardiothorac Imaging 2023;5:e220328.
6. Freire V, Guérini H, Campagna R, Moutounet L, Dumontier C, Feydy A, et al. Imaging of hand and wrist cysts: A clinical approach. AJR Am J Roentgenol 2012;199:W618-28.
7. Neto N, Nunnes P. Spectrum of MRI features of ganglion and synovial cysts. Insights Imaging 2016;7:179-86.
8. Sofka CM, Adler RS. Sonography of cubital bursitis. AJR Am J Roentgenol 2004;183:51-3.
9. Wang C, Song RR, Kuang PD, Wang LH, Zhang MM. Giant cell tumor of the tendon sheath: Magnetic resonance imaging findings in 38 patients. Oncol Lett 2017;13:4459-62.
10. Middleton WD, Patel V, Teefey SA, Boyer MI. Giant cell tumors of the tendon sheath: Analysis of sonographic findings. Am J Roentgenol 2004;183:337-9.
11. Dalei TR, Loya VK. Tendon sheath hemangioma. J Hand Microsurg 2019;11 Suppl 1:S22-5.
12. Shrateh ON, Jobran AW, Khatib M, Sulaiman S, Thalji F, Hussein S. Radiological diagnosis of median nerve lipoma: A case report from Palestine. Radiol Case Rep 2023;18:1248-52.
13. Jaovisidha S, Chen C, Ryu KN, Siriwongpairat P, Pekanan P, Sartoris DJ, et al. Tuberculous tenosynovitis and bursitis: Imaging findings in 21 cases. Radiology 1996;201:507-13.
14. Hage AN, Chick JF, Srinivasa RN, Bundy JJ, Chauhan NR, Acord M, et al. Treatment of venous malformations: The data, where we are, and how it is done. Tech Vasc Interv Radiol 2018;21:45-54.
15. Acord M, Srinivasan A. Management of venous malformations. Semin Intervent Radiol 2021;38:215-25.
16. Makhija LK, Bhattacharya S. Management of vascular anomalies: Review of institutional management algorithm. Indian J Plast Surg 2017;50:193-200.
17. Mehta PS, Gohil AR. A case report of rare incidence of benign vascular lesion of hand masquerading magnetic resonance imaging findings. Int J Res Orthop 2025;11:928-30.
18. Corvino A, Catalano O, Tagliati C, Cocco G, Tafuri D, Corvino F, et al. When a lump is not a cyst: A case of superficial venous aneurysm of the Hand diagnosed with high-resolution ultrasound. Diagnostics (Basel) 2025;15:1546.


How to Cite this Article: Saran JSRG, Devdass V, Anand D. Atypical Venous Malformation of the Volar Wrist Presenting as a Ganglion Cyst: Diagnostic Pitfalls and Surgical Insights – Case Report. Journal of Clinical Orthopaedics. July-December 2025;10(2):119-124.

 (Article Text HTML)  (Download PDF)