Dermoid Cyst – Causes, Symptoms, and Surgical Treatment
There are various health problems that may appear at birth or soon after. Dermoid cyst, for instance, is one such condition that may be congenital (present from birth). This article will inform you about dermoid cysts, their causes, treatment, and more!
What Is Meant By Dermoid Cyst?
Dermoid cyst, which is also known as dermal, epidermal inclusion or epidermoid cyst is a mass or collection of tissues that may contain oil, hair follicles, sweat glands, teeth, etc., on or in the skin. These cysts can be found anywhere in the body, however, most commonly they occur around the neck, face, head, or upper chest. These cysts can keep growing slowly but they are completely harmless. However, they do not get better on their own and require surgical intervention for removal.
Causes of Dermoid Cyst
Dermoid cysts in babies can be established by your doctor during your prenatal ultrasound scans. It has not been established why these cysts occur in babies; however, one of the most common reasons is when the skin or skin structures get trapped during the foetal development process. This happens because the skin layers may not grow together, which happens during the early stages of fetal development. In most cases, these cysts are present from birth and it is very unlikely that they may occur later in life.
What Are the Types of Dermoid Cyst?
The type or kind of dermoid cyst is established according to its location. In most cases the cysts form near the surface of the skin, in some cases, the cysts can be present deep inside the skin or body and thus may not be noticeable or can go undiagnosed for a long time. Here are some of the common types of dermoid cysts:
1. Periorbital Dermoid Cyst
This kind of dermoid cyst of the skin is usually present either on the left side of the left eyebrow or right side of the right eyebrow. Although this type of cyst is present at birth, it may not become evident until a few months or years after the birth of the child.
Symptoms: There may be very mild symptoms, but if there is any kind of infection present in the cyst, immediate medical intervention may be required. Here are some signs of dermoid cyst in case of infection:
- The skin may turn yellowish around the cyst.
- The skin surface may become swollen and can cause discomfort.
- The skin may turn red and inflamed.
- In some cases, the cyst may rupture.
2. Spinal Dermoid Cyst
This benign cyst is found in the spine area and does not spread to other regions or body parts. This kind of cyst is harmless but it may press against the spine or nerves in the spine and thus may require surgical removal.
Symptoms: You can notice the symptoms of this kind of cyst once it becomes big enough in size and starts putting pressure on the spine or spinal nerves. The location of the cyst will determine which body part it affects. However, here are some symptoms that may occur:
- Difficulty in walking.
- Losing bladder control.
- Experiencing tingling sensation or weakness in the legs or arms.
3. Ovarian Dermoid Cyst
These kinds of dermoid cysts are formed in the ovaries; however, they may not fiddle with ovarian functions. But there are other kinds of ovarian cysts that can affect the menstrual cycle of women. Also, like all other kinds of dermoid cysts, these are present from birth but may not get diagnosed until late in life.
Symptoms: The symptoms may become pronounced only when the cyst becomes large enough and under such circumstances, it may cause some of the following symptoms:
- Pain around the pelvic region.
- The pain may become severe during your menstrual periods.
In most cases, dermoid cysts are harmless and pose no serious threat. However, if the cysts around the face or neck get ruptured, then it may lead to the spreading of infection to the nearby tissues.
The cysts in the ovaries are also not of any grave concern as they are non-cancerous. However, sometimes these cysts can grow too big in size and may affect the position of ovaries, may twist them, or in some cases reduce the blood flow to the ovaries too. Any of these conditions may sometimes hamper with a woman’s ability to get pregnant.
Also, spinal dermoid cysts may injure the spine or the spinal nerves, if they become too pronounced or too large in size.
Usually, your doctor or medical practitioner will conduct a physical exam to examine the presence of a cyst, if any. However, if the presence or location of the cyst is at some sensitive place, such as the carotid artery in the neck or eye, then the doctor may conduct any of the following imaging tests:
1. MRI Scan
This procedure uses powerful radio waves and magnetic fields, help in obtaining detailed and more comprehensive images of the body.
2. CT Scan
This procedure uses a special X-ray imaging technique to create layered three-dimensional images of the tissues of the body.
These kinds of image testing help the doctor in identifying the exact location and extent of damage and also in knowing whether or not there is any high-risk condition or situation that requires immediate medical intervention.
Where either of the above two imaging may help in establishing pelvic dermoid cysts, pelvic examination or pelvic dermoid cyst ultrasound may be required to establish a pelvic dermoid cyst. In some cases, your doctor may also conduct a transvaginal ultrasound, where a thin wand-like imaging structure is inserted in the vagina to examine the lower abdomen and nearby areas.
How Are Dermoid Cysts Treated?
The only way to remove dermoid cysts is surgery. But before making the decision for surgery, the doctor may like to examine the symptoms, medical history, severity, risk of infection, tolerance to surgical procedure, and various other such factors. Once the decision for surgery is taken after considering all the important factors, here is what can be expected before, during, or after the surgical procedure:
Your doctor will give you various instructions with regards to what to eat, the medicines you take, and more. Make sure you follow them properly. The procedure requires the use of general anaesthesia, which means you may have to make transportation arrangements post the surgery.
In case of a periorbital dermoid cyst, the doctor will make a small incision near the hairline or close to the eyebrow and the cyst will be removed through the incision. The procedure may last up to half an hour.
In the case of spinal dermoid cysts, the doctor will perform microsurgery to remove the cyst. This procedure requires the use of very fine and small surgical instruments. The doctor opens up a very thin covering of the dura of the spine to make access to the cyst. You will be lying with your face down during the entire surgical procedure and your doctor will keep monitoring your nerve functions closely.
The most complicated surgery is the surgery that requires the removal of the ovarian dermoid cysts. If the cyst is not large enough and has not caused much harm to the ovary, then the doctor will remove the cyst only. This procedure is known as an ovarian cystectomy. However, if the cyst is large enough and has damaged a major part of the ovary, your doctor may remove the cyst as well as the affected ovary.
Mostly, the surgical procedure for the removal of a dermoid cyst is not a complicated procedure and can be performed as an outpatient procedure. This means that you can go home the same day after the surgery.
However, in case of spinal or ovarian dermoid cyst removal surgery, your doctor may like to keep you under observation in the hospital for a couple of days based on the complications in the surgery, if any. In some cases, the doctor may not remove the entire cyst but remove only a part of the cyst (this may occur mostly in cases of spinal dermoid cysts where the cyst may become entwined with the spinal nerves). Under such a situation also the doctor may advise you to stay in the hospital for monitoring the part of the cyst that remains in the body.
The recovery from surgery can usually take up to two to three weeks in most cases.
Dermoid cysts are harmless and, in most cases, painless lumps of the skin and if left untreated, they may continue to grow. Surgery has a good success rate and it also reduces the chances of infection, if any, from spreading it to nearby tissues or harming the body organs and causing other related complications. Before opting for it, it is important that you discuss your concerns regarding the surgery with your doctor.