Dermoid Cysts: Expectations vs. Reality

Dermoid cysts, also known as mature cystic teratomas, are lesions that can develop in various body parts. They are congenital, non-cancerous growths from the abnormal development of embryonic cells, retaining the potential to form a diverse array of tissues and structures.

These cysts frequently present a complex reality that contradicts patients’ initial expectations.

What is a Dermoid Cyst?

A dermoid cyst is a sac-like growth that contains normal tissue, developing unexpectedly in or under the skin. The term “dermoid” refers to its skin-like properties, while “cyst” indicates a lump containing various materials, such as fluid, bone, hair, nerves, sweat glands, and even teeth.

It can occur anywhere in the body. Some cause lumps on the skin surface, while others reside deeper inside the body. Dermoid cysts treatment usually does not cause harm and necessitates surgical removal since they do not disappear spontaneously, even though they may resemble tumours initially.

Types of Dermoid Cysts

Primarily, dermoid cysts occur on the head and neck. Periorbital dermoid cysts most commonly occur near the outside edge of the eyebrow. Other frequently observed dermoid cysts include ovarian dermoid cysts (on or in the ovary) and spinal dermoid cysts (on the spine).

However, rarer types like peribulbar dermoid cysts (on the surface of the eye), intracranial dermoid cysts (in the brain), nasal sinus dermoid cysts (inside the nose), and orbital dermoid cysts (around the bones of the eye socket) can also occur.

Who Might Develop a Dermoid Cyst?

Dermoid cysts are congenital, meaning they are present at birth. They arise when skin layers fail to grow together as they should during fetal development. The sac collects skin cells, tissues, and glands. And it continues to produce fluid, leading to the cyst’s growth.

These cysts are more commonly diagnosed in children under the age group of five years, with approximately seven in ten cases identified in this age group. Further, doctors diagnose around four in ten dermoid cysts at birth.

Causes of Dermoid Cysts

The primary cause of dermoid cysts is their congenital nature. They form during the early stages of fetal development when skin cells, tissues, and glands collect in a sac instead of merging as expected.

Symptoms of Dermoid Cysts

Most people with dermoid cysts do not experience any symptoms. However, as the cysts grow, some individuals may notice specific signs based on the cyst’s location and type:

• Periorbital Dermoid Cyst: A lump near the eyebrow’s edge may appear swollen with a yellowish tint. Over time, it can alter the shape of the surrounding bones.
• Ovarian Dermoid Cyst: Pain in the pelvic area, especially around menstruation, may be experienced.
• Spinal Dermoid Cyst: As the cyst grows, it may compress the spinal cord or nerves, leading to issues such as trouble walking, urinary incontinence, and weakness in the legs and arms.

Diagnosing a Dermoid Cyst

Healthcare providers can diagnose dermoid cysts in various ways, depending on their location:

• Physical Exam: If the cyst is close to the skin’s surface, the provider can visually inspect the cyst and the surrounding area.
• CT Scan or MRI: These Non-invasive imaging tests can provide detailed images of the cyst’s location, especially near sensitive areas like blood vessels or nerves.
• Pelvic or Transvaginal Ultrasound: These painless ultrasound techniques allow the visualisation of ovarian dermoid cysts by applying a probe to the skin or inserting a wand into the vagina.

Treatment for Dermoid Cysts

Surgical removal is the most effective treatment for dermoid cysts. The type of surgery depends on the specific cyst:

• Periorbital Dermoid Cyst: After cleaning the area and administering a local anaesthetic to minimise scarring, the surgeon removes the cyst through a small incision.
• Ovarian Dermoid Cyst: Minimally invasive surgery (ovarian cystectomy) may be used to remove the cyst while preserving the ovary. In cases of large cysts, removal of both the ovary and cyst may be necessary.
• Spinal Dermoid Cyst: Surgical removal with the help of a surgical microscope and microsurgery techniques is employed. The patient is under general anaesthesia and positioned face-down for better access.

Reducing the Risk and Potential Complications

Untreated dermoid cysts can lead to various complications if they grow over time. These complications may include damaging nearby bones, causing infections, injuring the spinal cord or nerves, rupturing the cyst, and inducing ovarian torsion (twisting of the ovaries).

When to Seek Medical Attention

If new symptoms arise or existing symptoms worsen, it is essential to consult a healthcare provider. You should seek immediate medical attention if the cyst becomes inflamed, causes pain, changes colour enlarges significantly, or ruptures.

Frequently Asked Questions