From the Guidelines
Dermoid cysts form during embryonic development when skin and skin structures become trapped within other tissues, resulting in the abnormal incorporation of ectodermal elements into areas where they don't typically belong. These cysts arise from the trapping of small segments of the developing skin layer (ectoderm) as the skin folds to form various structures during fetal development 1. The trapped cells continue to function as skin cells would, producing keratin and forming cyst walls lined with stratified squamous epithelium.
The cysts gradually enlarge as they accumulate sebaceous material, keratin debris, and sometimes hair follicles, sweat glands, and even teeth or bone fragments, depending on their location 1. This explains why dermoid cysts often contain diverse tissue types and can be found in various body locations, including the ovaries, testicles, face, neck, spinal cord, and brain. Unlike other cysts that might develop later in life due to blockages or injuries, dermoid cysts are congenital, meaning they are present from birth, though they may not become noticeable until they grow larger over time.
Some key characteristics of dermoid cysts include:
- They are usually benign, with dermoid cysts (mature teratomas) being the most common type of ovarian tumor 1
- They may have a characteristic appearance on scanning, with features such as hair, teeth, and cartilage
- Management of these tumors typically involves fertility-preserving surgery and adjuvant chemotherapy, especially in younger patients 1
- Dermoid cysts can account for up to 20% of all ovarian tumors, and are more common in younger patients, where they may account for over 75% of ovarian tumors 1
From the Research
Formation Mechanism of Dermoid Cysts
The formation mechanism of dermoid cysts is not explicitly described in the provided studies. However, some insights can be gained from the characteristics and behaviors of dermoid cysts:
- Dermoid cysts are a type of germ cell tumor, which suggests that they originate from the cells that give rise to the reproductive cells [@\5@].
- They are also known as mature cystic teratomas, which implies that they contain mature tissue from all three germ layers (ectoderm, mesoderm, and endoderm) [@\5@].
- The growth pattern of dermoid cysts has been observed to be linear, with an increase in volume following a cuboid sequence [@\4@].
Characteristics of Dermoid Cysts
Some key characteristics of dermoid cysts include:
- They are the most common germ cell tumors of the ovary in women of reproductive age [@\3@, @\5@].
- They can cause symptoms such as pain, abnormal vaginal bleeding, and ovarian torsion [@\5@].
- They can be diagnosed using transvaginal sonography and treated using laparoscopic surgery [@\5@].
- They can rupture and spill their contents, which can lead to chemical peritonitis [@\1@, @\2@].
Treatment and Management
The treatment and management of dermoid cysts typically involve:
- Laparoscopic surgery, which can include cystectomy, salpingo-oophorectomy, or partial oophorectomy [@\1@, @\2@, @\3@, @\5@].
- Careful handling of the cyst to minimize spillage and prevent chemical peritonitis [@\1@, @\2@, @\5@].
- Monitoring for potential complications, such as infection or malignant transformation [@\1@, @\2@, @\3@].