Surgical Care

Surgical excision is the treatment of choice in any localization.^[47]Surgically remove dermoid cysts. The average age at the time of surgery can vary widely; in 1 retrospective study of 159 patients, it ranged from age 1 month to 63 years.^[48]

In some patients, surgery should be performed even more carefully than usual because the fatty content of the cyst may spread to the surrounding tissues or anatomic structures, especially if the cyst is infected with bacteria. The spread of these contents can cause foreign body reactions and severe complications.

Minimally invasive surgical techniques have been successful in removing dermoid cysts from difficult locations, such as those on the tongue or the floor of the mouth. Intralingual dermoid cysts lead to lingual motility defects and speech problems. These cysts should be surgically removed to restore normal lingual function and to correct speech problems.

Intracranial, intramedullary, and ovarian dermoid cysts are difficult to treat. Sophisticated neurosurgical or gynecologic surgical techniques are often needed to remove the dermoid cyst and prevent possible complications. High-definition fiber tracking guidance may be beneficial in the resection of an intraparenchymal dermoid cyst by means of a minimally invasive endoscopic port.^[49]

In some patients with dermoid cysts on the forehead and brow, successful excision with endoscopy-assisted surgery have been described.^[50]In the reported cases, no complications (eg, paresthesia or numbness on the scalp) occurred. The absence of visible scarring is an additional advantage of endoscopy-assisted surgery.

Angular dermoid cyst excision using an eyelid crease approach may yield excellent cosmesis.^[51]External angular dermoid cysts can be excised using a minimally invasive subcutaneoscopic technique that involves placing incisions above the hairline to avoid scarring on the face.^[52]

Frontozygomatic removal through a blepharoplasty incision has been advocated for frontozygomatic dermoid cysts.^[53]

Questions

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Media Gallery

Dermoid cyst in an unusual location. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/lesions/d-cyst.jpg).

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

Zbigniew Ruszczak, MD, PhD Consultant Dermatologist and Allergist, Department of Medicine, Division of Dermatology, Sheikh Khalifa Medical City, Abu Dhabi, UAE; Consultant in Pediatric Dermatology, Wound Healing and On-Site-Drug Delivery Systems; Visiting Consultant in Dermatology and Dermatopathology, UMDNJ-New Jersey Medical School, Newark

Zbigniew Ruszczak, MD, PhD is a member of the following medical societies: American Academy of Dermatology, New York Academy of Sciences, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Albert C Yan, MD Section Chief, Associate Professor, Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine

Albert C Yan, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology, Society for Pediatric Dermatology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

Dermoid Cyst Treatment & Management

Surgical Care

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