Cystic Soft Tissue Lesions of the Hand

Cystic soft tissue lesions of the hand often pose a diagnostic challenge due to their broad range of differential diagnoses that include benign ganglion cysts as well as inflammatory and malignant conditions. Although most lesions are benign, atypical clinical or imaging features may suggest rare but significant pathologies that require timely recognition. This article provides a structured case-based overview of cystic and cystic-appearing soft tissue lesions of the hand, integrating each case with a brief review of relevant pathophysiology, imaging characteristics, and therapeutic considerations. The cases illustrate the spectrum of cystic lesions categorized as true cysts, tumors or tumor-like lesions with cystic features, and infectious and inflammatory entities. Special emphasis is placed on identifying imaging red flags in lesions that may mimic benign cysts, such as synovial sarcoma, and on the role of magnetic resonance imaging as the key imaging modality in ambiguous cases.