Dermoid cysts

Definition of Dermoid cyst of the ovary
Dermoid cyst of the ovary : A bizarre tumor, usually benign, in the ovary that typically contains a diversity of tissues including hair, teeth, bone, thyroid, etc.
A dermoid cyst develops from a totipotential germ cell (a primary oocyte) that is retained within the egg sac (ovary). Being totipotential, that cell can give rise to all orders of cells necessary to form mature tissues and often recognizable structures such as hair, bone and sebaceous (oily) material, neural tissue and teeth.
Dermoid cysts may occur at any age but the prime age of detection is in the childbearing years. The average age is 30. Up to 15% of women with ovarian teratomas have them in both ovaries. Dermoid cysts can range in size from a centimeter (less than a half inch) up to 45 cm (about 17 inches) in diameter.
These cysts can cause the ovary to twist (torsion) and imperil its blood supply. The larger the dermoid cyst, the greater the risk of rupture with spillage of the greasy contents which can create problems with adhesions, pain etc. Although the large majority (about 98%) of these tumors are benign, the remaining fraction (about 2%) becomes cancerous (malignant).
Removal of the dermoid cyst is usually the treatment of choice. This can be done by laparotomy (open surgery) or laparoscopy (with a scope). Torsion (twisting) of the ovary by the cyst is an emergency and calls for urgent surgery.
Dermoid cysts of the ovary are also called simply dermoids or ovarian teratomas.

Dermoid cyst
From Wikipedia, the free encyclopedia
A dermoid cyst is a cystic teratoma that contains developmentally mature skin complete with hair follicles and sweat glands, sometimes luxuriant clumps of long hair, and often pockets of sebum, blood, fat, bone, nails, teeth, eyes, cartilage, and thyroid tissue. Because it contains mature tissue, a dermoid cyst almost always is benign. The rare malignant dermoid cyst usually develops squamous cell carcinoma in adults; in babies and children it usually develops endodermal sinus tumor.
Some authors use the term dermoid cyst as a frank synonym for teratoma, meaning any teratoma, regardless of its histology or location. Others use it to mean any mature, cystic teratoma. These uses appear to be most common in gynecology and dermatology.
The term dermoid is sometimes used to mean dermoid cyst but this is unfortunately vague.
Location
A dermoid cyst can occur wherever a teratoma can occur.
Periorbital dermoid cysts
Dermoid cysts can appear in young children, often near the lateral aspect of the eyebrow (right part of the right eyebrow or left part of the left eyebrow). It often has a rubbery feel. These are sometimes watched and sometimes excised. An inflammatory reaction can occur if the dermoid cyst is disrupted.
Dermoid cysts can recur if not completely excised. Sometimes, complete excision is not practical if in a dumbbell configuration where the cyst extends through a suture line in the skull.
If the dermoid cysts appear on the medial aspect, the possibility of an encephalocele becomes greater and should be considered among the differential diagnosis.

Dermoid Cyst Removal Overview
A dermoid cyst is a saclike growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin.
Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. Superficial dermoid cysts on the face usually can be removed without complications. Removal of other, rarer dermoid cysts requires special techniques and training. These rarer dermoid cysts occur in 4 major areas:
•   Dermoid cysts in the brain: Dermoid cysts occur very rarely here. A neurosurgeon may need to remove them if they cause problems.
•   Dermoid cysts in the nasal sinuses: These are also very rare. Only a handful of cases involving dermoid cysts located here are reported each year. Removal of these cysts is extremely complicated.
•   Ovarian dermoid cysts: These growths can develop in a woman during her reproductive years. They can cause torsion, infection, rupture, and cancer. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis).
•   Dermoid cysts of the spinal cord: A sinus tract, which is a narrow connection from a deep pit in the skin, usually connects these very rare cysts to the skin surface. This type of dermoid cyst can become infected. Removal is often incomplete, but the outcome is usually excellent.
Dermoid Cyst Causes
Dermoid cysts are caused when skin and skin structures become trapped during fetal development. Their cell walls are nearly identical to those of the outer skin and may contain multiple skin structures such as hair follicles, sweat glands, and sometimes hair, teeth, or nerves.
When to Seek Medical Care
A doctor should be contacted in the following situations:
•   A cyst becomes painful or inflamed.
•   A cyst grows or changes color.
•   Removal is desired for cosmetic reasons.
Typically, removing a dermoid cyst is not an emergency procedure. If a dermoid cyst ruptures, becomes inflamed, or causes pain or fever, a person should seek immediate medical advice. Depending on the severity of pain or discomfort, a person might also consider visiting a hospital’s emergency department.

Exams and Tests
Prior to removal of superficial dermoid cysts on the face, a person should know the difference between cysts and other facial growths.
•   Because dermoid cysts stem from birth and grow slowly, a person usually notices them during childhood or early adulthood.
•   Dermoid cysts are firm and painless unless ruptured.
•   Dermoid cysts are not attached to the overlying skin.
In rare cases, a dermoid cyst extends into a structure deeper than skin, such as a facial cavity or an orbit. Some doctors recommend a CT scan or other imaging studies for these cases. This decision depends on the doctor’s suspicion of a deep-level cyst and after a determination of risk versus benefit.
Dermoid Cyst Removal Treatment
Self-Care at Home
Self-removal of facial cysts at home is not recommended because the cyst will grow back if not completely removed. Chances of infection, bleeding, and other complications increase for people who remove dermoid cysts themselves, especially since the person may not be able to differentiate between a harmless growth and other, more serious skin growths.

Medical Treatment
To remove a dermoid cyst, the doctor will clean the area over which the cyst is located, inject a local anesthetic, and make an incision directly over the cyst and attempt remove it completely.
Outlook
Barring the possible complications associated with any operation, removal of a dermoid cyst usually results in complete recovery.