A rare occurrence of ganglion cysts on the posterolateral aspect of the elbow without neurological manifestations: a case series and review of the literature
Keywords:elbow, ganglion, cyst
Background: The occurrence of ganglion cysts around the elbow is rare, and the occurrence of these lesions without any symptoms of compression to the nearby structures is even rarer. Most published cases of elbow ganglions have reported patients with symptoms relating to compression of the radial nerve, or branches thereof secondary to anteriorly located cysts. We present two cases of ganglions occurring on the posterolateral aspect of the elbow with no pressure symptoms to the radial nerve.
Case series: The first case is a 33-year-old male, with a seven-month history of a spontaneous, slow-growing mass on the posterolateral aspect of his left elbow. The second case is a 38-year-old female, with a 12-month history of a spontaneous mass on the posterolateral aspect of her left elbow. In both cases, the reason for presentation was the unsightly elbow with an enlarging mass. The lesions were painless and both patients were neurologically intact with no restriction on range of motion of the joint. Both patients underwent excision of the mass for aesthetic reasons.
Discussion: Patients with elbow ganglions usually have cysts located anterior to the radiocapitellar joint and almost invariably present with an associated motor, or less commonly, a sensory deficit of the radial nerve. Various treatment modalities have been reported; however, the vast majority undergo open surgical excision due to their association with progressive neurological symptoms. This usually leads to resolution of symptoms, and recurrence is rare.
Conclusion: The clinical presentation of the two patients reported in this case series seems to be far less frequent than patients presenting with a neuropathy of the radial nerve due to an anteriorly located elbow ganglion. It cannot, however, be excluded that there is an underreporting of asymptomatic elbow ganglions. According to our review of the English literature, this is only the third report of an asymptomatic elbow ganglion in the lateral compartment of the elbow.
Level of evidence: Level 5