From the Guidelines
Dermoid tumors are benign growths that contain mature tissue derived from all three germ cell layers, typically including skin, hair, sebaceous glands, and sometimes teeth or bone, with a risk of malignant transformation of less than 1%. They most commonly occur in the ovaries but can also be found in other locations such as the skin, brain, or spine. These tumors develop from trapped embryonic tissue during fetal development. Ovarian dermoid tumors (also called mature cystic teratomas) typically affect women of reproductive age and account for a significant portion of all ovarian tumors.
Key Characteristics
- They are usually benign, with malignant transformation occurring in less than 1% of cases, as noted in a study by Gupta et al 1.
- They can be found in various locations, including the ovaries, skin, brain, or spine.
- They contain mature tissue from all three germ cell layers.
Diagnosis and Management
- Diagnosis is often made through imaging, with ultrasound being a key tool for characterizing these lesions, as discussed in the study by Parazzini et al 1.
- Management may involve surgical removal, either through laparoscopy or open surgery, depending on the size and location of the tumor, with the goal of preventing recurrence and ruling out malignant transformation.
- For women concerned about fertility, ovary-sparing surgery is typically possible and preferred when treating these benign tumors.
Follow-Up
- Regular follow-up after removal is recommended, though recurrence rates are generally low, as indicated by Valentin et al 1.
- For dermoid tumors that are not excised, yearly ultrasound follow-up is recommended due to the small risk of malignant transformation, as suggested by the study 1.
From the Research
Definition and Characteristics of Dermoid Tumors
- Dermoid tumors, also known as mature teratomas, are benign embryonal tumors with a slow growth rate 2.
- They are the consequence of ectodermal components becoming trapped along with their closure sites and account for the most common germinative ovarian tumor in reproductive-aged women 2.
- These tumors are often evaluated using imaging techniques such as computed tomography, magnetic resonance imaging, pelvic ultrasonography, or transvaginal ultrasound 2.
Treatment and Management of Dermoid Tumors
- Laparoscopic surgery is a widely accepted treatment for dermoid tumors, with the goal of removing the tumor while minimizing the risk of spillage and chemical peritonitis 3, 4, 5.
- The choice of surgical procedure, such as laparoscopic cystectomy or salpingo-oophorectomy, depends on the size and location of the tumor, as well as the patient's overall health 3, 5.
- Studies have shown that laparoscopic surgery is a safe and effective procedure for removing dermoid tumors, with minimal risk of complications such as chemical peritonitis 3, 4, 5.
Complications and Risks Associated with Dermoid Tumors
- Dermoid tumors can be complicated by torsion, rupture, and malignant change, with torsion being the most frequent complication and malignant change being the most lethal 6.
- The risk of malignant change is higher in larger tumors, and a more aggressive surgical approach may be necessary to salvage patients with locally advanced disease 6.
- Spillage of dermoid contents during surgery is a common postoperative complication, but the risk of chemical peritonitis can be minimized with proper surgical technique and postoperative care 2, 3, 4, 5.