Recurrence of Ganglion Cysts Following Re-excision

The recurrence of ganglion cysts after surgical excision has a reported rate of 4% to 40%. Recurrence rateafter revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cystsin patients who underwent a secondary excision procedure. With Institutional Review Board approval, we retrospectively identified by CPT code and reviewed charts ofpatients who had recurrent ganglion cyst excision performed over a five-year period (2010 – 2014). Recurrence was definedas reappearance of a cyst in the same area as it was previously. Demographic information including recurrences andrevision surgeries was collected in addition to outcome variables such as patient satisfaction, pain levels, and functionallimitations. Out of the 42 revision cases identified 20 patients were reached. Mean time to recurrence of the cyst after the firstganglion cyst excision was 2.5 years (range: 1 month - 12 years). After the second ganglion cyst excision, three patients(15%) had a recurrence, each occurring within one year (mean: 11 months; range: 9-12). One of the three patients underwenta third successful ganglion cyst excision. The other two patients declined surgical intervention to date. Patients without asecond recurrence (n=17) reported an average pain score of 0.1 (range: 0-2) on a scale of 1-10. Three (18%) reported somedifficulty with day-to-day activities due to their scar. Seven (41%) patients reported at least transient numbness or tingling.Mean satisfaction was 9.8 on a scale of 1-10, and 100% reported that they would undergo another ganglion cyst excisionshould they ever have another recurrence. Patients should be advised about the risk of recurrence after re-excision of ganglion cysts, which was notedto be 15% in our cohort. This rate of recurrence is similar to that of primarily excised cysts.Level of evidence: III