Abstract
Ganglion cysts (GCs) are the most common benign soft tissue tumors of the wrist, most commonly located dorsally and less commonly volarly. Accurate identification of the pedicle (stalk) connecting the cyst to the joint from which it originates is crucial for successful surgical planning and preventing recurrence. In this case report, we present a rare case of GC, which appeared to be volar-radial on physical examination but was shown to be connected to the dorsal scapholunate joint by magnetic resonance imaging (MRI). Based on preoperative MRI findings, open surgical excision was performed, and the pedicle's relationship with the scapholunate joint was confirmed intraoperatively. Following surgery, painless, full range of motion was achieved, and no recurrence was observed. This case highlights that the pedicle of volarly located cysts may have a dorsal origin and that preoperative MRI identification of the distal pedicle pattern increases surgical safety.

Key words: dorsal origin; ganglion cyst; long pedicle; volar wrist