What are dermoid cysts?
Ovarian dermoid cysts (also called mature cystic teratomas) are a type of benign (non-cancerous) growth that can develop on the ovaries. They form from cells that have the ability to become different types of body tissue. Because of this, dermoid cysts can contain a mixture of tissues normally found elsewhere in the body, such as hair, skin, fat, or even teeth. Although this can sound alarming, these cysts are very common and usually harmless. Dermoid cysts tend to grow slowly and often cause no symptoms for a long time. They are most commonly found in people of reproductive age but can occur at any age, including after menopause. Most dermoid cysts are discovered by chance during an ultrasound for another reason.
Understanding Dermoid Cysts
Many ovarian dermoid cysts cause no symptoms and are found incidentally during imaging for another issue. When symptoms do occur, they are usually related to the size or position of the cyst. Common symptoms may include:
- Lower abdominal or pelvic pain, this may be mild, intermittent, or persistent.
- A feeling of fullness or pressure in the lower abdomen.
- Bloating or abdominal swelling, especially if the cyst is large.
- Pain during sex (dyspareunia).
- Changes in bowel or bladder habits, such as needing to pass urine more often, due to pressure on nearby organs.
A key complication to be aware of is ovarian torsion, where the ovary twists around its blood supply. This is more likely with dermoid cysts because they can be heavier. Symptoms of torsion include sudden, severe pelvic pain, nausea, and vomiting, and require emergency medical attention.
Diagnosing Endometrial Hyperplasia
Dermoid cysts develop from germ cells, which are cells in the ovary that have the potential to form eggs. These cells are capable of developing into many types of body tissue. Occasionally, these germ cells grow abnormally and form a dermoid cyst containing mixed tissue such as hair, skin, or fat. The exact reason this happens is not fully understood, but dermoid cysts:, Aren’t caused by anything you did, such as diet, lifestyle, or sexual activity., Aren’t usually linked to hormones, unlike some other ovarian cysts., Are almost always benign, although they can grow over time. They are one of the most common types of benign ovarian tumours in people of reproductive age. Ovarian dermoid cysts are often found incidentally, meaning they are discovered during scans for another reason, because they may cause no symptoms. When symptoms occur, imaging tests are used to confirm the diagnosis.
- Ultrasound This is usually the first and main test. An ultrasound can show the cyst’s size, shape, and typical features, such as fluid, fat, or calcified areas (like teeth or bone), which strongly suggest a dermoid cyst. A transvaginal scan may provide a closer, more detailed view.
- MRI Scan An MRI may be used if the diagnosis is unclear on ultrasound. MRI offers very detailed images and is particularly good at identifying the fat content characteristic of dermoid cysts.
- Blood Tests Blood tests such as CA-125 are not used to diagnose dermoid cysts, but may be done if the cyst looks unusual or if doctors want to rule out other causes. High results do not necessarily mean cancer, many benign conditions cause raised CA-125.
Treatment Options
The treatment for ovarian dermoid cysts depends on your symptoms, the size of the cyst, and whether it could affect fertility or cause complications.
Conservative Management
If the cyst is small and not causing symptoms, your doctor may recommend watchful waiting. This usually involves regular ultrasound scans to check that the cyst is not growing or causing problems. Dermoid cysts do not usually go away on their own, but many remain stable for years without causing issues.
Surgical Options
Surgery is the only way to confirm the cyst is benign and prevent potential complications such as ovarian torsion, rupture, or very rarely, malignancy.
- Laparoscopic surgery (keyhole surgery) This is the most common approach. Small incisions are made in the abdomen to remove the cyst while preserving the ovary when possible. Recovery is usually quick.
- Laparotomy (open surgery) Rarely needed, typically reserved for very large cysts or if there is concern about cancer.
Surgery decisions are guided by cyst size, symptoms, and patient preferences, including whether fertility preservation is important.