Dermoid Cyst: Causes, Symptoms & Treatment

A dermoid cyst is a cavity lined with epidermal tissue. It is classified as a teratoma.

What is a dermoid cyst?

A dermoid cyst is a germ cell tumor. Germ cell tumors originate in the germinal tracts. This means that they originate in the ovaries of a woman or the testicles of a man. Germ cell tumors can be both benign and malignant. The benign tumors are much more common. They are called dermoid cysts. One of the typical features of a dermoid cyst or dermoid is that it has fully developed tissue such as skin, teeth, glandular portions or hair. In some cases, there is a risk that a malignant tumor will develop from a benign teratoma. Dermoid cysts particularly affect women who are of childbearing age. It is not uncommon for the cysts to form on both sides of the body. Among benign ovarian tumors, dermoid cysts account for between 10 and 20 percent.

Causes

A dermoid cyst forms from tissue in which dislocation has occurred during embryonic development. Often, the cysts have tissue from all three cotyledons. The contents of the cyst are oily or doughy. Hair is also frequently present. Furthermore, there is a possibility that cartilage, bone, blood, sebum, nails, teeth, and even thyroid tissue may be present in the dermoid cyst. Likewise, neuroectodermal tissue such as glial cells is not uncommon. A teratoma arises from a stem cell. These cells can develop into very different cells. The stem cell from which a teratoma is formed, such as a dermoid cyst, is considered embryonic or germinal tissue. Teratomas are believed to be present before birth and thus congenital. However, since they do not cause any symptoms for a long time, they can be detected late. As mentioned above, dermoid cysts occur most frequently on the female ovaries or the male testicles. However, they sometimes show up in other areas of the body, such as the rump.

Symptoms, complaints, and signs

Noticeable symptoms do not initially result from a dermoid cyst. Only when the teratoma reaches a certain size are protrusions or abdominal pain possible. If the pressure on the adjacent parts of the body increases, there is a risk of problems with defecation or urination. If a rupture of the capsule or a stem rotation of the teratoma occurs, this leads to an acute abdomen accompanied by severe abdominal pain. Furthermore, irregularities in the female menstrual cycle and menstrual cramps may occur. In addition, the abdominal girth increases and affected individuals suffer from a poor general condition. Effects on other parts of the body are also conceivable. Thus, in some cases, hyperthyroidism becomes apparent. A dermoid cyst is actually benign. Sometimes, however, a malignant tumor develops from it, but this happens only rarely. Thus, a malignant manifestation occurs in only one percent of all cases. In women, the occurrence of a teratoma that is malignant from the beginning is just as rare. In men, on the other hand, all teratomas are malignant.

Diagnosis

If the development of a dermoid cyst is suspected, the physician first conducts a discussion with the patient. In doing so, he inquires about the time from which the complaints occurred. He then palpates the abdomen as part of a physical examination. This is supplemented by an X-ray examination and sonography (ultrasound examination) of the abdomen. To determine whether the tumor is benign or malignant, a tissue sample is taken for microscopic examination in a laboratory. A surgical procedure is usually required to remove the tissue sample. In most cases, the dermoid cyst takes a favorable course because the teratoma can be easily removed. Even in the case of a malignant tumor, the prognosis is better than for other types of tumors. Thus, successful removal is usually possible.

Complications

Most often, a dermoid cyst is diagnosed late. It causes patients to experience abdominal pain and cramping in the stomach. Similarly, there may be difficulty or discomfort with urination and defecation. These activities are not infrequently associated with a burning pain. As a result, the quality of life is reduced.In some cases, patients drink less to prevent frequent urination, which leads to dehydration. Women may suffer from increased menstrual cramps due to the dermoid cyst. This is also accompanied by severe mood swings, which can have a negative effect on the psyche. In the worst case, a malignant tumor can develop from the dermoid cyst, which must be removed. Malignant tumors are more common in men, while women usually suffer almost exclusively from benign tumors. The removal of the tumor takes place surgically and does not lead to any further complications if the tumor has not spread widely or affected other tissues. Chemotherapy is usually necessary after surgery. The earlier the dermoid cyst is detected, the less the secondary damage or complications. If successfully removed, life expectancy is not reduced.

When should you see a doctor?

If a dermoid cyst is suspected, a physician should be consulted promptly. The typical symptoms usually do not appear until the later stages of the disease. Therefore, if symptoms occur, it is necessary to react immediately. For example, anyone who experiences stabbing abdominal pain or suddenly has problems with bowel movements or urination must have these symptoms medically clarified and, if necessary, treated. If irregularities in the female cycle are noticed, this also indicates a dermoid cyst. Basically, the disease makes itself felt through a variety of different symptoms. It is therefore advisable to pay close attention to the body’s signals and to make an appointment with a gynecologist in case of abnormalities. At the latest when weight gain is noticed for which there is no other cause, a medical explanation is advisable. The dermoid cyst is usually harmless and can be treated without complications. However, if it remains untreated, a malignant tumor may form, which will cause further complications. Therefore, at the first sign of a dermoid cyst, consult a physician and have the cause determined.

Treatment and therapy

In the case of dermoid cysts, surgical removal is generally recommended. For this purpose, an abdominal endoscopy (laparoscopy) usually takes place. If the teratoma has settled in the abdomen, the physician administers general anesthesia. If laparoscopy is not possible, an open abdominal incision (laparotomy) is performed. Because the contents of the dermoid cyst can spill into the abdominal cavity, the surgeon must be very gentle during the operation. In some patients, it is necessary to remove the entire ovary along with the teratoma. Just like the benign dermoid cyst, a malignant teratoma is also surgically removed. If the surgeon does not find malignant cells during the operation, removal of the tumor is sufficient. If, on the other hand, malignant cells are found, the surgical procedure must be extended to neighboring lymph node stations. In addition, chemotherapy is given, in which cisplatin is administered. In most cases, chemotherapy is very effective. Surgery must also be performed in the case of a testicular dermoid cyst because of the risk of malignant tissue developing. Since the growth of the teratoma is rapid, surgery should be performed as soon as possible. Chemotherapy may also be necessary in this case following surgery. Surgery is also required for a dermoid cyst on the coccyx. In most cases, treatment leads to complete recovery of the patient.

Outlook and prognosis

Dermoid cyst has a good prognosis, provided it is detected, diagnosed, and treated in a timely manner. The germ cell tumor is usually removed under local anesthesia. Afterwards, with good wound care, the patient is free of symptoms within a short time. If complications occur during the procedure or in the subsequent healing phase, most patients experience a delay in the healing process. Inadequate wound care rarely leads to blood poisoning. However, if it occurs, the patient is in a life-threatening condition. Without seeking medical treatment for the dermoid cyst, the risk of the cyst mutating and becoming a malignant tumor increases. Cancer can always have a fatal outcome. Therefore, the prognosis in these situations must be individualized.In severe cases, cancer cells detach from the mutated and thus malignant cyst. They are transported via the blood to another location in the organism and can cause the formation of new metastases there. Despite a successful removal of the dermoid cyst, a new formation can occur at any time in the further course. Therefore, regular check-ups are essential for maintaining health. If new dermoid cysts have formed, there is also a good prognostic outlook if the cysts are removed early.

Prevention

Preventive measures against a dermoid cyst are not known. Thus, the

Teratoma is already congenital.

Follow-up care

In most cases, the person affected by a dermoid cyst has no special or direct measures and options for aftercare. In this regard, the patient is first dependent on early detection to prevent further complications or worsening of symptoms. Only after a comprehensive diagnosis can further treatment be carried out to alleviate the symptoms. Since self-healing cannot occur in the process, the main priority in dermoid cyst is early detection of the disease. In most cases, those affected are dependent on taking medication to alleviate the symptoms with the help of hormones. Care must be taken to ensure that the medication is taken regularly and in the correct dosage. If any questions arise, a doctor should be consulted in any case. It is not uncommon for dermoid cyst to require surgical intervention. After the procedure, patients should definitely rest and take care of their body. Strenuous or stressful activities are not advisable in order not to put unnecessary strain on the body. As a rule, the dermoid cyst can be treated well, so that there is no reduced life expectancy due to this disease.

What you can do yourself

When the congenital teratoma reaches a certain size, the symptoms become progressively worse. Thus, the quality of life of the affected women is significantly reduced. In most cases, surgical removal must now be performed. Nevertheless, those affected can take some measures to alleviate the symptoms. Monk’s pepper and lady’s mantle help with existing cycle disorders and hormone fluctuations. They have a balancing effect on the hormone balance. Homeopathy recommends the substances Apis melifica and Lachesis. However, before self-treatment, a consultation with an experienced homeopath or alternative practitioner should be made. Bach flower therapy can alleviate inner restlessness and states of tension. It should also be checked whether there is hyperacidity in the body. This can be responsible for many complaints. Alkaline baths and a diet rich in vital substances as well as the intake of sufficient fluids – especially still mineral waters – can counteract this. Furthermore, abstaining from meat is said to be beneficial. In general, nutrition is of particular importance. Numerous experience reports show that fasting can help with existing cysts. Massages to stimulate the lymph also help the body to heal itself. Acupuncture, acupressure or foot reflexology massages can alleviate pain, discomfort and anxiety. In some cases, hyperthyroidism also occurs. This should be treated by an endocrinologist. For existing mood swings, aromatherapy could be a possibility: Neroli, the oil of orange blossom has a mood-lifting and relaxing effect.