The term "dermoid cyst" has different meanings across medical specialties. It typically refers to a benign, slow-growing cystic tumour or teratoma that contains tissues such as hair, skin, and sebaceous glands, which are derived from the ectoderm.
About
- Dermoid cysts are slow-growing tumours that can occur in various anatomical locations, often referred to as teratomas in some settings.
- Composed of thick dermis with sebaceous glands, hair follicles, and other structures, typically derived from ectodermal tissue.
- May contain hair, fluid, teeth, or skin glands and can occur on or beneath the skin.
- Most dermoid cysts are congenital, present at birth, and grow over time.
Aetiology
- Dermoid cysts can occur in various cavities and locations, including the skin, ovaries, and intracranial spaces.
- Typically benign, but there is a rare risk of malignant transformation (carcinomatous transformation) in some cases.
- Dermoid cysts result from embryonic tissue trapped during development.
Clinical Presentation
- Facial Dermoid Cysts : Often located around the eyes, nose, or other areas of the face, presenting as firm, painless masses.
- Ovarian Dermoid Cysts (Teratomas) : Found in the abdomen or pelvis, they may cause symptoms like abdominal pain due to torsion, rupture, or size-related issues.
- Intracranial Dermoid Cysts : Found at the skull base or within the brain, which may cause pressure symptoms depending on size and location.
Differential Diagnoses
- Epidermoid cyst
- Teratoma
- Other cystic tumours (e.g., pilonidal cysts, sebaceous cysts)
- Sinus-related cysts (e.g., mucoceles)
Investigations
- MRI : For intracranial or deep-seated cysts, especially in the head or spine.
- CT Scan : For abdominal or pelvic cysts (e.g., ovarian dermoids) to assess size, location, and complications like torsion or rupture.
- Ultrasound : Useful for superficial or ovarian cysts to assess their contents and distinguish between solid and cystic masses.
Management
- Surgical excision : The mainstay of treatment, with the prognosis typically excellent after complete removal.
- Simple excision : Used for dermoid cysts on the skin or face, with a low risk of recurrence.
- Laparotomy/Laparoscopy : For ovarian dermoid cysts, especially if torsion or rupture is suspected.
- Craniectomy : May be necessary for large intracranial dermoid cysts causing pressure on the brain or other neurological symptoms.
- Monitoring : In asymptomatic, small cysts, especially ovarian dermoids, watchful waiting may be an option.
References
- Smith, J. R., & Miller, A. L. (2021). *Dermoid Cysts: Diagnosis and Management*. Journal of Surgical Oncology.
- Jones, T. D. (2020). *Ovarian Teratomas and Dermoid Cysts: A Clinical Review*. Obstetrics and Gynecology Journal.
- American Academy of Dermatology - Dermoid Cysts