From the Guidelines
Yes, dermoid cysts can grow during pregnancy, and their growth is related to hormonal stimulation, although they tend to grow more slowly than other types of ovarian cysts. The elevated levels of estrogen and progesterone during pregnancy can stimulate the growth of these benign ovarian tumors, also known as mature teratomas 1. Most dermoid cysts are discovered incidentally during routine prenatal ultrasounds and remain asymptomatic throughout pregnancy. However, some may cause complications such as pain, torsion, or rupture.
Management of dermoid cysts during pregnancy typically involves monitoring the cyst with ultrasound, and surgery is generally avoided unless complications arise, such as severe pain, rapid growth, or signs of malignancy 1. If intervention is necessary, the second trimester is usually considered the safest time for surgical removal. After delivery, persistent dermoid cysts may be evaluated for removal, especially if they are large (greater than 5-6 cm) or causing symptoms.
Some key points to consider in the management of dermoid cysts during pregnancy include:
- The risk of malignancy is approximately 2% of adnexal masses in pregnancy 1
- Ultrasound is the most important tool in the workup of adnexal masses, allowing for differentiation between benign and malignant masses 1
- Laparoscopy is preferable to laparotomy due to decreased patient pain and length of hospital stay, although laparotomy is still considered safe in pregnancy when necessary 1
- The decision to intervene on a dermoid cyst during pregnancy should be made on the basis of expert clinical opinion, balancing the risks and benefits of intervention for a particular patient, and allowing for shared decision-making 1.
From the Research
Dermoid Cysts and Pregnancy
- Dermoid cysts are subcutaneously located cystic masses that contain epithelium and adnexal structures, and can be found in various parts of the body, including the ovaries and head and neck region 2.
- The growth of dermoid cysts can be accelerated during pregnancy, which may lead to severe symptoms such as respiratory and deglutition problems 2.
- Studies have shown that dermoid cysts can grow in size during pregnancy, with some cases reporting rapid growth and complications such as torsion and rupture 3, 4.
Management of Dermoid Cysts During Pregnancy
- The management of dermoid cysts during pregnancy is crucial to prevent complications and ensure a successful obstetric outcome 3, 5, 4.
- Surgical intervention may be necessary to remove the dermoid cyst, especially if it is large or causing symptoms 3, 5, 4.
- Laparoscopy is a viable option for the management of dermoid cysts during pregnancy, especially in the second trimester 5, 4.
- Conservative management may be appropriate for small dermoid cysts (<6 cm) that are not causing symptoms, as they are unlikely to grow or cause complications during pregnancy 6.
Complications of Dermoid Cysts During Pregnancy
- Dermoid cysts can cause complications during pregnancy, including torsion, rupture, and obstruction of the reproductive tract 3, 4.
- Large dermoid cysts (>6 cm) are more likely to cause complications and may require surgical intervention 3, 5, 4.
- The risk of complications can be reduced by early diagnosis and management of dermoid cysts during pregnancy 3, 5, 4.