Dermoid cyst natural history: Difference between revisions
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==Overview== | ==Overview== | ||
Common complications of periorbital dermoid cysts include inflammation and recurrence when not completely excised.<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref> | 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.<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> Common complications of periorbital dermoid cysts include [[inflammation]] and recurrence when not completely excised.<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref> Rupture is the most common complication of spinal dermoid cysts.<ref name=kl> Spinal dermoid cyst. Radiopedia. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 11, 2016.</ref> Common complications of intracranial dermoid cysts include compression of adjacent structures from the mass effect and rupture of the cysts.<ref name=wx>Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.</ref><ref name="pmid19846186">{{cite journal| author=Jacquin A, Béjot Y, Hervieu M, Biotti D, Caillier M, Ricolfi FC et al.| title=[Rupture of intracranial dermoid cyst with disseminated lipid droplets]. | journal=Rev Neurol (Paris) | year= 2010 | volume= 166 | issue= 4 | pages= 451-7 | pmid=19846186 | doi=10.1016/j.neurol.2009.09.003 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19846186 }} </ref> Infection is the most common complication of dermoid cysts of the floor of the mouth.<ref name="pmid21922020">{{cite journal| author=Makos C, Noussios G, Peios M, Gougousis S, Chouridis P| title=Dermoid cysts of the floor of the mouth: two case reports. | journal=Case Rep Med | year= 2011 | volume= 2011 | issue= | pages= 362170 | pmid=21922020 | doi=10.1155/2011/362170 | pmc=PMC3172983 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922020 }} </ref> [[Malignant]] transformation usually into [[squamous cell carcinoma]] is a rare complication of dermoid cysts.<ref name="pmid16714456">{{cite journal| author=Osborn AG, Preece MT| title=Intracranial cysts: radiologic-pathologic correlation and imaging approach. | journal=Radiology | year= 2006 | volume= 239 | issue= 3 | pages= 650-64 | pmid=16714456 | doi=10.1148/radiol.2393050823 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16714456 }} </ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> 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.<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref> | |||
==Complications== | ==Complications== | ||
===Ovarian | *[[Malignant]] transformation usually into [[squamous cell carcinoma]] is a rare complication of dermoid cysts.<ref name="pmid16714456">{{cite journal| author=Osborn AG, Preece MT| title=Intracranial cysts: radiologic-pathologic correlation and imaging approach. | journal=Radiology | year= 2006 | volume= 239 | issue= 3 | pages= 650-64 | pmid=16714456 | doi=10.1148/radiol.2393050823 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16714456 }} </ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | ||
*Common complications of ovarian dermoid cysts include:<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref><ref>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | |||
**Torsion | ===Ovarian Dermoid Cyst=== | ||
*Common complications of ovarian dermoid cysts include:<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | |||
**[[Torsion]] | |||
**Rupture | **Rupture | ||
**Infection | **Infection | ||
**[[Malignant]] transformation, usually into [[squamous cell carcinoma]] (adults) or rarely into endodermal sinus tumours (children) | |||
===Periorbital Dermoid Cyst=== | ===Periorbital Dermoid Cyst=== | ||
*Common complications of periorbital dermoid cysts include:<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref> | *Common complications of periorbital dermoid cysts include:<ref name=kl>Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 11, 2016</ref> | ||
**Inflammation | **[[Inflammation]] | ||
***When a dermoid cyst is disrupted, it results in an inflammatory reaction. | ***When a dermoid cyst is disrupted, it results in an inflammatory reaction. | ||
**Recurrence when not completely excised | **Recurrence when not completely excised | ||
===Spinal | ===Spinal Dermoid Cyst=== | ||
*Rupture is the most common complication of spinal dermoid cysts.<ref> Spinal dermoid cyst. Radiopedia. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 11, 2016.</ref> | *Rupture is the most common complication of spinal dermoid cysts.<ref name=kl> Spinal dermoid cyst. Radiopedia. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 11, 2016.</ref> | ||
**Rupture of the cyst may result in the dissemination of fat droplets into the [[subarachnoid]]al and ventricular spaces which may lead to [[ventriculitis]], [[arachnoiditis]], and eventually mental disorders and [[coma]].<ref name="pmid23508636">{{cite journal| author=Sharma M, Mally R, Velho V| title=Ruptured conus medullaris dermoid cyst with fat droplets in the central canal [corrected]. | journal=Asian Spine J | year= 2013 | volume= 7 | issue= 1 | pages= 50-4 | pmid=23508636 | doi=10.4184/asj.2013.7.1.50 | pmc=PMC3596585 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23508636 }} </ref> | |||
===Intracranial Dermoid Cyst=== | |||
*Common complications of intracranial dermoid cysts include:<ref name=wx>Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.</ref><ref name="pmid19846186">{{cite journal| author=Jacquin A, Béjot Y, Hervieu M, Biotti D, Caillier M, Ricolfi FC et al.| title=[Rupture of intracranial dermoid cyst with disseminated lipid droplets]. | journal=Rev Neurol (Paris) | year= 2010 | volume= 166 | issue= 4 | pages= 451-7 | pmid=19846186 | doi=10.1016/j.neurol.2009.09.003 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19846186 }} </ref> | |||
**Mass effect | |||
***Compression of adjacent structures, e.g. [[optic chiasm]] | |||
**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.<ref name="pmid21922020">{{cite journal| author=Makos C, Noussios G, Peios M, Gougousis S, Chouridis P| title=Dermoid cysts of the floor of the mouth: two case reports. | journal=Case Rep Med | year= 2011 | volume= 2011 | issue= | pages= 362170 | pmid=21922020 | doi=10.1155/2011/362170 | pmc=PMC3172983 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922020 }} </ref> | |||
==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]].<ref name="pmid17160798">{{cite journal| author=Altay H, Kitiş O, Calli C, Yünten N| title=A spinal dermoid tumor that ruptured into the subarachnoidal space and syrinx cavity. | journal=Diagn Interv Radiol | year= 2006 | volume= 12 | issue= 4 | pages= 171-3 | pmid=17160798 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17160798 }} </ref> | |||
*In patients with malignant transformation, prognosis depends on the stage of the disease.<ref name="pmid16714456">{{cite journal| author=Osborn AG, Preece MT| title=Intracranial cysts: radiologic-pathologic correlation and imaging approach. | journal=Radiology | year= 2006 | volume= 239 | issue= 3 | pages= 650-64 | pmid=16714456 | doi=10.1148/radiol.2393050823 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16714456 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
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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
- Malignant transformation usually into squamous cell carcinoma is a rare complication of dermoid cysts.[6][2]
Ovarian Dermoid Cyst
- Common complications of ovarian dermoid cysts include:[1][2]
- Torsion
- Rupture
- Infection
- Malignant transformation, usually into squamous cell carcinoma (adults) or rarely into endodermal sinus tumours (children)
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
- Inflammation
Spinal Dermoid Cyst
- Rupture is the most common complication of spinal dermoid cysts.[1]
- Rupture of the cyst may result in the dissemination of fat droplets into the subarachnoidal and ventricular spaces which may lead to ventriculitis, arachnoiditis, and eventually mental disorders and coma.[7]
Intracranial Dermoid Cyst
- Common complications of intracranial dermoid cysts include:[3][4]
- Mass effect
- Compression of adjacent structures, e.g. optic chiasm
- 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
- Mass effect
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
- ↑ 1.0 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
- ↑ 2.0 2.1 2.2 2.3 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016
- ↑ 3.0 3.1 Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.
- ↑ 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.
- ↑ 5.0 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.
- ↑ 6.0 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.
- ↑ 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.
- ↑ 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.