Preliminary Report of the Effectiveness of Tetracycline Sclerotherapy in Treatment of Ganglion

Ganglion, a benign cyst, most common soft tissue tumor of the hand, usually occurs in the hand, wrist, and foot. It is difficult to treat as reoccurrence is common after surgery and also following other treatment procedures. In this study, sclerotherapy technique in 20 patients treated using a solution of tetracycline after aspiration is described. Most of the patients in this study were between the ages of 20 and 35 years. 16 patients had ganglion on the dorsum of the wrist, 2 patients had bilateral ganglion, and 2 patients had ganglion on the dorsum of the foot. Under aseptic conditions, the ganglions were aspirated using size 21？G needles, and then 1？mL equivalent to 100？mg/mL solution of tetracycline was injected. In the postoperative followup ranging between 18 months to 5 years, 2 reoccurrences were noticed that required the same technique. This procedure is simple, safe, effective, and cheap when compared to surgery and other nonsurgical procedure of treating ganglion. 1. Introduction Ganglion accounts for two-thirds of all hand tumours [1]. The commonest site of occurrence is the dorsum of the wrist, the volar aspect of the wrist, and in the fingers in relation to the flexor tendon sheath. Ganglion also occurs on the dorsum of the foot. Surgical treatment is required when they cause symptoms. The common indications for surgery are pain or the size of the ganglion for cosmetic reasons. Recurrence after surgical excision is extremely common [2]. An alternative to surgical excision is aspiration with or without injection of local steroids and various other techniques [3, 4]. This is a preliminary report of the result of aspiration followed by instillation of tetracycline as a sclerosant. This procedure is simple, cheap, and has several advantages which outweigh the benefit of surgery. The advantages are the following.(1)No need for anesthesia, local or general.(2)No scar and hence better cosmetic result.(3)It is an office procedure without any complication such as hand edema and peripheral nerve injuring, and above all it is cost effective when compared to cost of surgical therapy. 2. Patients and Methods This prospective study commenced in September 2002 and is still ongoing. This study had approval of the hospital ethical committee in accordance with the Helsinki Declaration of 2010. The patients in this study have been followed up for a minimum of 18 months and some up to 5？yrs with no sign of recurrence. The major complaint was cosmetic as well as pain. Each patient has his or her ganglion aspirated with 5？mL syringe and 21？G needle. The