Dermoid Cyst
A dermoid
cyst is a
teratoma
that
contains
developmentally
mature skin,
with hair
follicles
and sweat
glands,
sometimes
luxuriant
clumps of
long hair,
and often
pockets of
sebum,
blood, fat,
bone, nails,
teeth, eyes,
cartilage,
and thyroid
tissue.
Because it
contains
mature
tissue, a
dermoid cyst
almost
always is
benign. The
rare
malignant
dermoid cyst
usually
develops
squamous
cell
carcinoma.
Some
authors use
the term
dermoid cyst
as a frank
synonym for
teratoma,
meaning any
teratoma,
regardless
of its
histology or
location.
Others use
it to mean
any mature,
cystic
teratoma.
These uses
appear to be
most common
in
gynecology
and
dermatology.
The term
dermoid is
sometimes
used to mean
dermoid cyst
but this is
unfortunately
vague.
Location
A dermoid
cyst can
occur
wherever a
teratoma can
occur.
Periorbital
dermoid
cysts
Dermoid
cysts can
also appear
in young
children,
often near
the lateral
aspect of
the eyebrow
(right part
of the right
eyebrow or
left part of
the left
eyebrow). It
often has a
rubbery
feel. These
are
sometimes
watched and
sometimes
excised. An
inflammatory
reaction can
occur if the
dermoid cyst
is
disrupted.
Dermoid
cysts can
recur if not
completely
excised.
Sometimes,
complete
excision is
not
practical if
in a
dumbbell
configuration
where the
cyst extends
through a
suture line
in the
skull.
If the
dermoid
cysts appear
on the
medial
aspect, the
possibility
of an
encephalocele
becomes
greater and
should be
considered
among the
differential
diagnosis.
A dermoid
cyst is not
a pilonidal
cyst
A small
dermoid cyst
on the head
(skull
sutures, and
midline:
sinus, nose,
palate,
tongue,
under the
tongue,
etc.) or the
coccyx can
be difficult
to
distinguish
from a
pilonidal
cyst. This
is partly
because both
can be full
of hair. A
pilonidal
cyst is a
pilonidal
sinus that
is
obstructed.
Any teratoma
near the
body surface
may develop
a sinus or a
fistula, or
even a
cluster of
these. Such
is the case
of Canadian
Football
League
linebacker
Tyrone
Jones, whose
teratoma was
discovered
when he blew
a tooth out
of his nose.
Treatment
for dermoid
cyst is
surgical
complete
removal,
preferably
in one piece
and without
any spillage
of cyst
contents.
Marsupialization,
a surgical
technique
often used
to treat
pilonidal
cyst, is
inappropriate
for dermoid
cyst due to
the risk of
malignancy. |