Dermoid cyst natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

The majority of patients with dermoid cysts are asymptomatic. If left untreated, dermoid cysts gradually increase in size and produce symptoms depending upon their anatomical location. Common complications of ovarian dermoid cysts include torsion, rupture, and infection.[1][2] Common complications of periorbital dermoid cysts include inflammation and recurrence when not completely excised.[1] Rupture is the most common complication of spinal dermoid cysts.[1] Common complications of intracranial dermoid cysts include compression of adjacent structures from the mass effect and rupture of the cysts.[3][4] Infection is the most common complication of dermoid cysts of the floor of the mouth.[5] Malignant transformation usually into squamous cell carcinoma is a rare complication of dermoid cysts.[6][2] Depending on the anatomical location of the tumor, the prognosis may vary.

Natural History

The majority of patients with dermoid cysts are asymptomatic. If left untreated, dermoid cysts gradually increase in size and produce symptoms depending upon their anatomical location.[1]

Complications

Ovarian Dermoid Cyst

Periorbital Dermoid Cyst

  • Common complications of periorbital dermoid cysts include:[1]
    • Inflammation
      • When a dermoid cyst is disrupted, it results in an inflammatory reaction.
    • Recurrence when not completely excised

Spinal Dermoid Cyst

  • Rupture is the most common complication of spinal dermoid cysts.[1]

Intracranial Dermoid Cyst

  • Common complications of intracranial dermoid cysts include:[3][4]
    • Mass effect
    • Rupture (spontaneous, traumatic, or iatrogenic (at resection))
      • Fat droplets from the ruptured cysts may disseminate into the subarachnoid space and ventricles which may result in the development of aseptic chemical meningitis

Dermoid Cysts of the Floor of the Mouth

  • Infection is the most common complication of dermoid cysts of the floor of the mouth.[5]

Prognosis

  • Depending on the anatomical location of the tumor, the prognosis may vary.
  • Although benign and slow growing, spinal, ovarian, and intracranial dermoid cysts carry a risk of rupture spontaneously, during surgery or after a traumatic event which is associated with a high morbidity and mortality.[8]
  • In patients with malignant transformation, prognosis depends on the stage of the disease.[6]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016
  2. 2.0 2.1 2.2 2.3 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016
  3. 3.0 3.1 Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.
  4. 4.0 4.1 Jacquin A, Béjot Y, Hervieu M, Biotti D, Caillier M, Ricolfi FC; et al. (2010). "[Rupture of intracranial dermoid cyst with disseminated lipid droplets]". Rev Neurol (Paris). 166 (4): 451–7. doi:10.1016/j.neurol.2009.09.003. PMID 19846186.
  5. 5.0 5.1 Makos C, Noussios G, Peios M, Gougousis S, Chouridis P (2011). "Dermoid cysts of the floor of the mouth: two case reports". Case Rep Med. 2011: 362170. doi:10.1155/2011/362170. PMC 3172983. PMID 21922020.
  6. 6.0 6.1 6.2 Osborn AG, Preece MT (2006). "Intracranial cysts: radiologic-pathologic correlation and imaging approach". Radiology. 239 (3): 650–64. doi:10.1148/radiol.2393050823. PMID 16714456.
  7. Sharma M, Mally R, Velho V (2013). "Ruptured conus medullaris dermoid cyst with fat droplets in the central canal [corrected]". Asian Spine J. 7 (1): 50–4. doi:10.4184/asj.2013.7.1.50. PMC 3596585. PMID 23508636.
  8. Altay H, Kitiş O, Calli C, Yünten N (2006). "A spinal dermoid tumor that ruptured into the subarachnoidal space and syrinx cavity". Diagn Interv Radiol. 12 (4): 171–3. PMID 17160798.


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