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Ganglion cysts often grow back after surgery

Published: Thursday, March 27 1997 12:00 a.m. MST

Question: Ganglion cysts plague my 15-year-old on his left hand. Three cysts disappeared on their own, and he had surgery to remove a stubborn, painful one. After that, another appeared, and he says it also hurts. The doctor says we should wait and see. Is this expected? Did the surgeon miss getting the entire cyst, so it grew back? Could this be cancerous?

- T.D.

Answer: Your son has had a lifetime quota of ganglion cysts, the soft lump affairs often found at the wrist and ranging from BB to peach-stone size.

Why ganglia form or why they fill with the characteristic - jelly to egg-white consistency - material are unknown.

Surgical removal enjoys popularity, even though re-formation occurs in about one in four cases. Usually, that happens because some remnant of the cyst stalk gets left behind. Or a bit of cyst sloughs off to seed neighboring tissue, where it germinates new growths.

Your son seems to be back to square one - a new cyst with pain. If it is where wrist movement has been compromised and is causing pain, then yes, surgery is again in order.

I have seen enough ganglia to argue convincingly for the wisdom of removal to end pain. Others would argue for anticipation of disappearance of the cyst left alone. No matter. Coward that I am, I would give serious consideration to surgery, and probably have it, especially if pain were involved.

All surgically removed tissue, cyst or tumor, is examined microscopically at the hospital. If it is anything but a ganglion cyst, its nature would be reported to the doctor.

Question: I have been frustrated by cholesterol that remains high in spite of dietary changes and weight loss. About a year ago, I read something about cholesterol in a person who had genital herpes. It said such people don't process cholesterol well. My doctor drew a blank. Have you run into this fact?

- S.P.

Answer: I dug, S.P., and was rewarded with two bones of reference to a link between herpes infection and stubbornly high cholesterol. Be advised that they were two rather obscure references appearing in research journals. Such embryonic knowledge seldom survives to merge unaided into mainstream medicine.

But there it is, its meaning unclear and probably of doubtful significance.

Were I you, I would continue traditional methods of bringing cholesterol in control, and would include drug therapy, if necessary. I am sure it promises more substantial success than pursuit of half-developed vagrant theories.

If you do have genital herpes, the connection might interest your doctor. I can give him the sources. I hate to waste research time.

Question: My husband has cellulitis in his foot. He was hospitalized and had lots of antibiotics, and he still cannot bear weight on the foot. We are otherwise in the dark. Can you explain cellulitis? He is diabetic.

- M.R.

Answer: Briefly, cellulitis is infection of skin cells and tissue just below the skin-cell level with either staphylococcus or streptococcus germs. Sometimes, even minute scratches allow entry and growth of those skin bacteria.

Spread can be rapid.

Diabetes plays a role by hindering normal healing.

Generally, cellulitis responds to antibiotics in a matter of two to four weeks - for your husband, certainly by the time you read this.

To learn more about controlling cholesterol with diet, send for a copy of the Health Letter report on the subject. Send Enclose $3 and a self-addressed, stamped (55 cents) No. 10 envelope to: Dr. Donohue - SR117, P.O. Box 5539, Riverton, NJ 08077-5539.

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