Dermoid cysts are small, sac-like pockets that develop under the skin. They often contain elements typically found in skin layers, such as oil, sweat glands, or hair follicles. Over time, the accumulation of oil and sweat can cause the cyst to grow. These cysts may be present at birth or appear later in life. They are commonly found on the face, neck, or scalp but can also develop in other parts of the body. Dermoid cysts, also known as teratomas, are unique because they may include a variety of tissues, such as hair, bone, fat, nails, teeth, cartilage, or even thyroid tissue.
While dermoid cysts grow slowly and are typically non-cancerous, complications can arise in rare cases. When malignant, they may lead to squamous cell cancer, usually occurring in older adults. In infants or young children, they occasionally develop into a specific type of tumor called an endodermal sinus tumor. Though commonly harmless, dermoid cysts on the face, neck, or chest can cause discomfort or cosmetic concerns, often necessitating surgical removal. They are also the most common orbital or preorbital tumors seen in children.
### What Are Dermoid Cysts?
In simple terms, a dermoid cyst is a growth or sac that develops near the surface of the skin. These cysts can form during a baby’s development in the womb and often contain hair, skin, and oil-producing glands. They typically remain painless unless they rupture or become infected. While most superficial dermoid cysts are easily removed, more complex or rare cysts might require advanced surgical techniques.
Dermoid cysts can form in four less common but more serious areas of the body:
1. **Brain**: Rare dermoid cysts can form in the brain and may require removal if they cause symptoms like headaches or neurological issues.
2. **Nasal Sinus**: Cysts in the nasal sinus are unusual and may pose complications if not carefully removed.
3. **Ovaries (Ovarian Cysts)**: In women, cysts can form on or inside the ovary during reproductive years. These can cause pain, infections, or even rupture, potentially leading to serious complications.
4. **Spinal Cord**: Dermoid cysts in the spine can connect to the skin through a sinus tract, increasing the risk of infection. Their removal is complex but often necessary.
Dermoid cysts generally grow due to trapped glands and tissues producing oil and sweat, which leads to their gradual enlargement. These cysts do not heal or shrink on their own, so surgical removal is usually required to prevent long-term issues.
### Types of Dermoid Cysts
Dermoid cysts are classified based on their location:
– **Preorbital Cysts**: Found near the eyebrows, these cysts are usually present at birth but might not be noticeable until later. They rarely affect vision or health unless infected and can be addressed with minor surgery.
– **Ovarian Cysts**: These cysts develop on or inside an ovary, often without affecting its function. However, undetected ovarian dermoid cysts can cause complications, making routine pelvic exams important.
– **Spinal Cysts**: These benign cysts form on the spinal cord. While they rarely cause symptoms, a growing spinal dermoid cyst can press on nerves, leading to mobility issues or other complications.
### Characteristics of Dermoid Cysts
Dermoid cysts typically form when cells or tissues that belong on the skin’s surface become misplaced during fetal development. These misplaced cells can grow erratically, leading to the formation of a cyst. Though mostly benign, these cysts may cause issues due to their size, location, or the impact on surrounding tissues.
For example:
– A large cyst in the neck may press on the throat, affecting breathing or swallowing.
– Brain or spinal cysts can cause frequent headaches, weakness, or tingling sensations.
– Ovarian cysts can lead to pelvic pain, nausea, or rupture, creating the risk of bleeding or serious infections.
Even though these cysts are usually harmless, doctors often recommend removing them to avoid future complications.
### Symptoms of Dermoid Cysts
Symptoms vary depending on the cyst’s location:
– **Preorbital Cysts**: These appear as small, movable lumps near the skin surface. They may turn red and swollen if infected.
– **Ovarian Cysts**: Symptoms include pelvic pain, especially on one side, which might worsen during menstruation.
– **Spinal Cysts**: These cysts can affect nerves, causing tingling sensations, weakness, or difficulty walking. Incontinence or other nerve-related issues may also occur.
In general, dermoid cysts look like lumps under the skin that can sometimes shift when touched. The skin over the cyst may appear normal or have a blueish tint.
### Causes
The exact cause of dermoid cysts isn’t clear, but they are believed to result from developmental irregularities during early pregnancy.
– **Preorbital Cysts**: Develop when skin layers fail to form properly, creating sacs of trapped tissues and glands that grow over time.
– **Ovarian Cysts**: These form during embryonic development, containing misplaced skin cells and tissues.
– **Spinal Cysts**: Often associated with a condition called spinal dysraphism, where parts of the neural tube fail to close during development.
### Diagnosis and Treatment
Doctors diagnose dermoid cysts using physical exams, imaging tests like CT or MRI scans, and ultrasounds for deeper cysts, especially ovarian or spinal types.
Treatment typically involves surgical removal, particularly when cysts are painful, infected, or growing. Self-removal is strongly discouraged, as incomplete extraction can lead to infection or regrowth. Surgery involves localized anesthesia, making it a safe and effective option for most superficial cysts.
#### Surgical Options
– **Preorbital Cysts**: Removed with hidden incisions near the eyebrow or hairline to avoid visible scarring.
– **Ovarian Cysts**: Require advanced procedures like laparoscopy, and in some cases, removal of the ovary if damage is severe.
– **Spinal Cysts**: These involve precise surgeries to minimize damage while carefully removing as much of the cyst as possible.
Recovery generally takes two to three weeks, but more complex procedures, like spinal surgeries, may require prolonged healing times.
#### Modern Techniques: Drainage and Ablation
For many cysts, especially those near bony structures, newer minimally invasive methods like drainage and ablation can be effective. Ablation involves inserting a small needle into the cyst, using plasma energy to destroy it, and allowing the body’s natural healing process to clear the remaining tissue.
### Conclusion
Although dermoid cysts are typically benign and harmless, their growth or location can lead to complications over time. If you suspect a dermoid cyst, it’s important to consult a specialist. Surgical removal is often straightforward and prevents potential issues like infection, rupture, or interference with critical structures. With advances in medical technology, treatments for most dermoid cysts are safe and effective, offering patients relief and improved quality of life.