- Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD more...
The term dermoid cyst does not appear to be restricted to a single kind of lesion nor is it used in only a single medical discipline. The term dermoid cyst can be found in the vocabulary of dermatologists, dermatopathologists, general pathologists, gynecologists, neurosurgeons, or pediatricians. If asked, all of these clinicians would most probably define and describe dermoid cysts differently. For example, gynecologists and general pathologists might say that a dermoid cyst is a cystic tumor of the ovary. In contrast, neurosurgeons tend to view a dermoid cyst is associated with a congenital cyst of the spine or an intracranial congenital cyst. For pediatricians and dermatologists, dermoid cyst means subcutaneous cysts, which are usually congenital.
In all disciplines, however, the common factor is the presence of a solitary, or occasionally multiple, hamartomatous tumor. The tumor is covered by a thick dermislike wall that contains multiple sebaceous glands and almost all skin adnexa. Hairs and large amounts of fatty masses cover poorly to fully differentiated structures derived from the ectoderm.
Depending on the location of the lesion, dermoid cysts may contain substances such as nails and dental, cartilagelike, and bonelike structures. If limited to the skin or subcutaneous tissue, dermoid cysts are thin-walled tumors that contain different amounts of fatty masses; occasionally, they contain horny masses and hairs.
Dermoid cysts in the skin and subcutis occur mostly on the face, neck, or scalp.
In addition to the skin, dermoid cysts can be intracranial, intraspinal, or perispinal. Intra-abdominal cysts, such as cystic tumors of the ovary or omentum, occur as well.
No information is available about the prevalence of dermoid cysts. In gynecology, the literature describes dermoid cysts as relatively rare tumors, a cystic teratoma that most often occurs in individuals aged 15-40 years. In neurosurgery, dermoid cysts are rare. In dermatology and pediatrics, dermoid cysts are relatively uncommon.
Of the 2639 eyelid tumors from a Chinese study, the 5 most common eyelid benign ones were inflammatory lesions, melanocytic nevi, papillomas, dermoid cysts and epidermoid cysts, and epithelial cysts.
No racial predilection is apparent; however, most cases of dermoid cysts in the literature are described in white persons.
Dermoid cysts of the ovary are sex restricted, that is, they occur only in the female population. In other dermoid cysts, no sex predilection has been found.
Dermoid cysts have been described in persons of all ages.
Dermoid cysts on the face, neck, or scalp are subcutaneous cysts that are usually present at birth. Intracranial or perispinal dermoid cysts are most often found in infants, children, or young adolescents.
Intra-abdominal dermoid cysts are described in females aged 15-40 years. For example, cystic teratoma is a relatively rare tumor that most often occurs in females aged 15-40 years.
Most dermoid cysts on the floor of the mouth occur in individuals aged 10-30 years. There are few descriptions of oral dermoid cysts in newborns or children.
If dermoid cysts are diagnosed early and treated with complete surgical excision, the prognosis is good, and no further complications are expected.
In patients with carcinomatous transformation, the prognosis depends on the stage of the malignant disease (locally limited or spreading) and the success of therapy.
Although dermoid cysts are located in connection with the spinal channel (as described in neurosurgery literature), no deaths are directly linked to ruptures of the cyst or to the spreading of fatty and occasionally, infected masses in subarachnoid, ventricular, or subdural compartments. However, rupture or spread can lead to severe neurologic complications such as secondary spinal subdural abscesses.
Yan J, Li Y, Chen Q, Ye X, Li J. Rare orbital cystic lesions in children. J Craniomaxillofac Surg. 2015 Mar. 43(2):238-43. [Medline].
Xu XL, Li B, Sun XL, Li LQ, Ren RJ, Gao F. [Clinical and pathological analysis of 2639 cases of eyelid tumors]. Zhonghua Yan Ke Za Zhi. 2008 Jan. 44(1):38-41. [Medline].
Kiratli H, Bilgic S, Sahin A, Tezel GG. Dermoid cyst of the lacrimal gland. Orbit. 2005 Jun. 24(2):145-8. [Medline].
Koreen IV, Kahana A, Gausas RE, Potter HD, Lemke BN, Elner VM. Tarsal dermoid cyst: clinical presentation and treatment. Ophthal Plast Reconstr Surg. 2009 Mar-Apr. 25(2):146-7. [Medline].
Gonsalves SR, Lobo GJ, Mendonca N. Dermoid cyst: an unusual location. BMJ Case Rep. 2013 Nov 8. 2013:[Medline].
Maurice SM, Burstein FD. Disappearing dermoid: fact or fiction?. J Craniofac Surg. 2012 Jan. 23(1):e31-3. [Medline].
Scolozzi P, Lombardi T, Jaques B. Congenital intracranial frontotemporal dermoid cyst presenting as a cutaneous fistula. Head Neck. 2005 May. 27(5):429-32. [Medline].
Tas A, Yagiz R, Altaner S, Karasalihoglu AR. Dermoid cyst of the parotid gland: first pediatric case. Int J Pediatr Otorhinolaryngol. 2010 Feb. 74(2):216-7. [Medline].
Kahraman A, Kahveci R. A giant dermoid cyst. Dermatol Surg. 2008 Sep. 34(9):1273-5. [Medline].
Choi HJ, Kim SH, Lee JH. Unusual Presenting Tadpole-Shaped Dermoid Cyst on Eyebrow. J Craniofac Surg. 2016 May. 27 (3):e281-2. [Medline].
Nicollas R, Guelfucci B, Roman S, Triglia JM. Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol. 2000 Sep 29. 55(2):117-24. [Medline].
Acree T, Abreo F, Smith BR, Bagby J, Heard JS. Diagnosis of dermoid cyst of the floor of the mouth by fine-needle aspiration cytology: a case report. Diagn Cytopathol. 1999 Feb. 20(2):78-81. [Medline].
Bonilla JA, Szeremeta W, Yellon RF, Nazif MM. Teratoid cyst of the floor of the mouth. Int J Pediatr Otorhinolaryngol. 1996 Dec 5. 38(1):71-5. [Medline].
Vargas Fernandez JL, Lorenzo Rojas J, Aneiros Fernandez J, Sainz Quevedo M. [Dermoid cyst of the floor of the mouth]. Acta Otorrinolaringol Esp. 2007 Jan. 58(1):31-3. [Medline].
Zeltser R, Milhem I, Azaz B, Hasson O. Dermoid cysts of floor of the mouth: report of four cases. Am J Otolaryngol. 2000 Jan-Feb. 21(1):55-60. [Medline].
Devine JC, Jones DC. Carcinomatous transformation of a sublingual dermoid cyst. A case report. Int J Oral Maxillofac Surg. 2000 Apr. 29(2):126-7. [Medline].
Miles LP, Naidoo LC, Reddy J. Congenital dermoid cyst of the tongue. J Laryngol Otol. 1997 Dec. 111(12):1179-82. [Medline].
Myssiorek D, Lee J, Wasserman P, Lustrin E. Intralingual dermoid cysts: a report of two new cases. Ear Nose Throat J. 2000 May. 79(5):380-3. [Medline].
Sichel JY, Dano I, Halperin D, Chisin R. Dermoid cyst of the eustachian tube. Int J Pediatr Otorhinolaryngol. 1999 Apr 25. 48(1):77-81. [Medline].
Carroll CM, Gaffney R, McShane D. Congenital nasal dermoids in children. Ir J Med Sci. 1997 Jul-Sep. 166(3):149-51. [Medline].
Min HJ, Hong SC, Kim KS. The Usefulness of Three-Dimensional Reconstruction Computed Tomography in the Nasal Dermoid Cyst. J Craniofac Surg. 2016 May. 27 (3):819-20. [Medline].
Garrett JE, Cartwright PC, Snow BW, Coffin CM. Cystic testicular lesions in the pediatric population. J Urol. 2000 Mar. 163(3):928-36. [Medline].
Calabrò F, Capellini C, Jinkins JR. Rupture of spinal dermoid tumors with spread of fatty droplets in the cerebrospinal fluid pathways. Neuroradiology. 2000 Aug. 42(8):572-9. [Medline].
Carvalho GA, Cervio A, Matthies C, Samii M. Subarachnoid fat dissemination after resection of a cerebellopontine angle dysontogenic cyst: case report and review of the literature. Neurosurgery. 2000 Sep. 47(3):760-3; discussion 763-4. [Medline].
Karabulut N, Oguzkurt L. Tetraventricular hydrocephalus due to ruptured intracranial dermoid cyst. Eur Radiol. 2000. 10(11):1810-1. [Medline].
Mazumdar A, Vaiphei K, Verma GR. Multiple dermoid cysts of omentum. J Postgrad Med. 1997 Apr-Jun. 43(2):41-2. [Medline].
Davis GL. Malignant melanoma arising in mature ovarian cystic teratoma (dermoid cyst). Report of two cases and literature analysis. Int J Gynecol Pathol. 1996 Oct. 15(4):356-62. [Medline].
Ayhan A, Tuncer ZS, Bilgin F, Kucukali T. Squamous cell carcinoma arising in dermoid cyst. Eur J Gynaecol Oncol. 1996. 17(2):144-7. [Medline].
Ro EY, Thomas RM, Isaacson GC. Giant dermoid cyst of the neck can mimic a cystic hygroma: using MRI to differentiate cystic neck lesions. Int J Pediatr Otorhinolaryngol. 2007 Apr. 71(4):653-8. [Medline].
Thway K, Polson A, Pope R, Thomas JM, Fisher C. Extramammary Paget disease in a retrorectal dermoid cyst: report of a unique case. Am J Surg Pathol. 2008 Apr. 32(4):635-9. [Medline].
Arishima H, Takeuchi H, Kitai R, Yamauchi T, Kikuta KI. Vascular Leiomyoma of the Scalp with a Small Deformity on the Skull Mimicking a Dermoid Cyst. Pediatr Dermatol. 2012 Feb 22. [Medline].
Gleizal A, Abouchebel N, Lebreton F, Beziat JL. Dermoid cyst of the tongue: an association of dermoid cyst with bronchogenic epithelium. J Craniomaxillofac Surg. 2006 Mar. 34(2):113-6. [Medline].
Fernandez-Miranda JC, Engh JA, Pathak SK, et al. High-definition fiber tracking guidance for intraparenchymal endoscopic port surgery. J Neurosurg. 2009 Nov 27. [Medline].
Lin SD, Lee SS, Chang KP, Lin TM, Lu DK, Tsai CC. Endoscopic excision of benign tumors in the forehead and brow. Ann Plast Surg. 2001 Jan. 46(1):1-4. [Medline].
Cozzi DA, Mele E, d'Ambrosio G, Totonelli G, Frediani S, Spagnol L. The eyelid crease approach to angular dermoid cysts in pediatric general surgery. J Pediatr Surg. 2008 Aug. 43(8):1502-6. [Medline].
Agrawal V, Acharya H, Agarwal P, Sekhon V, Sharma D. Subcutaneoscopic excision of external angular dermoid cyst in children without conspicuous scarring. Asian J Endosc Surg. 2013 Aug. 6(3):241-4. [Medline].
Nelson KE, Mishra A, Duncan C. Upper blepharoplasty approach to frontozygomatic dermoid cysts. J Craniofac Surg. 2011 Nov. 22(6):e41-4. [Medline].
Jacquin A, Bejot Y, Hervieu M, et al. [Rupture of intracranial dermoid cyst with disseminated lipid droplets.]. Rev Neurol (Paris). 2009 Oct 19. [Medline].
Tatlidede S, Egemen O, Ozkaya O, Erol O. Witch nose: an embarassing metaphor for nasal tip dermoid cysts. J Craniofac Surg. 2011 Sep. 22(5):1948-51. [Medline].