Question: A couple weeks ago I injured my hand / wrist playing soccer. My orthopedic hand specialist ordered an MRI. Yesterday I met with him to get the results. The bone injury doesn't seem to be that serious (cast 4-6 weeks to heal it)... but my Dr. informed me that the Radiologist found a "cystic-appearing intramuscular lesion" and that this "probably reflects a ganglion cyst in an atypical location" but that "follow MR imaging with and without contrast would be helpful to exclude a pseudocystic solid neoplastic mass."

My wife and I are about to have twins after 5 years of fertility treatments, pregnancy losses, etc. I am a 34 year old male. I scheduled this follow up MRI but won't have that and the results for a couple weeks.

I am extremely worried about this. I have several questions that I'm hoping you can help me with. Attached is the MRI report so you can see all of the details.
1) I am concerned that this would be an "atypical location" for a ganglion cyst. In your opinion how likely / unlikely is it for this to be an intramuscular cyst?
2) Are the facts that this is T1 hypointense, no XXXXXXX solid, and hemorrhagic complex components a good thing? I'm assuming no XXXXXXX solids are definitely good but is T1 hypointense in line with a ganglion cyst?
3) If this is not a cyst and it is something else, how likely would it be cancer versus a benign tumor?

Thanks!

Thanks you so much for your help. I do have some follow up questions:

1) What from the MRI report makes you say that it wouldbe stage 1? Thats great to hear but I'd like to know why you believe that to be the case if it is malignant.

2) I am already scheduled for the MRI with and without contrast. Will that be a waste of my time meaning that I will have to do a FNAC regardless of the new MRI findings? Or is there a good chance that this new MRI will be able to confirm it is a cyst meaning no need to biopsy?

3) Is hypointense on T1 a good thing? Does that align with it being a cyst?

4) In your opinion if this is benign is it likely a cyst or would it more likely be some other type of benign tumor like a myxoid since it is intramuscular?

Thanks!

Thanks so much! I do have another question... you mentioned "with the given history I think it is an inflammatory collection of fluid inside muscle as a result of trauma."

Two things regarding this... my soccer injury was just 1.5 weeks before this MRI, could a ganglion cyst of this size form that quickly and appear like this in that short amount of time?

Also, now that I've been told about this mass I've been thinking hard to figure out if I've ever noticed anything unusual with the palm of my left hand. I used to lift weights regularly and seem to remember (at least a year ago, quite possibly even longer than that) doing bench presses and feeling some pain in my left palm and having to rotate my grip some to ease the pain when doing bench presses...

If this pain was caused by this mass and that was at least a year ago, does that support it being a cyst? What I'm wondering is if the pain was caused by a cancerous mass and that was over a year ago, would it be expected that this mass would look differently after a year plus on MRI? Would it likely be causing more outward issues by now?

Besides this recent injury I don't remember another injury to this hand that would've caused the trauma causing the cyst but I can't say for sure. Just wondering if 1) a cyst like this could quickly form in 1.5 weeks after an injury and 2) more than likely b/c of the bench press pain over a year ago it has been there for some time now and wondering if that supports it being a cyst or gives more suspicion to malignancy.

Thanks!