What are the other Names for this Condition? (Also known as/Symptoms)

• Mature Cystic Teratoma (Dermoid Cyst) of Ovary
• Ovarian Dermoid Cyst
• Ovarian Mature Cystic Teratoma (Dermoid Cyst)

What is Dermoid Cyst of Ovary? (Condition/background Information)

• Teratoma of ovary is a rare type of ovarian tumor that arises from the germ cells in females. Most teratoma tumors are either mature or immature. A majority of benign teratomas are mature, while a majority of malignant teratomas are immature
• Dermoid Cyst of Ovary is a type of mature cystic teratoma. However, unlike mature cystic teratomas that consist of tissues from the germ layer, namely ectoderm, mesoderm, and endoderm; a dermoid cyst has only hair, skin, and adnexal structures
• It is the most common germ cell tumor involving the ovary, reported in the medical literature. Nearly, 7 in 10 benign ovarian tumors observed during the child-bearing phase of women are Ovarian Dermoid Cysts
• The Dermoid Cyst of Ovary is a benign slow-growing tumor. It usually consists of a single cyst filled with sebaceous material. The cause of formation of this teratoma type is unknown. Also, presently, the risk factors for the same are not well-established
• In many cases, no signs and symptoms of teratoma are observed and these tumors are diagnosed incidentally. Some tumors may grow to large sizes and cause obstructive signs and symptoms
• The treatment of Dermoid Cyst of Ovary involves surgery in most cases. In a majority of cases, the prognosis is excellent with appropriate early treatment, since it is a benign tumor. However, some tumors may undergo a malignant transformation; in which case, the prognosis depends upon several factors including the stage of the tumor

Who gets Dermoid Cyst of Ovary? (Age and Sex Distribution)

• Dermoid Cysts of Ovary are common tumors that are often seen in young girls and women in their reproductive phase
• In some women, the tumor is diagnosed after menopause. 1 in 5 germ cell ovarian tumors observed in postmenopausal women are dermoid cysts
• No specific racial or ethnic group predilection is noted

What are the Risk Factors for Dermoid Cyst of Ovary? (Predisposing Factors)

• Currently, no definite risk factors have been identified for Dermoid Cyst of Ovary

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dermoid Cyst of Ovary? (Etiology)

The cause of development of Dermoid Cyst of Ovary is generally unknown. It is believed that abnormal differentiation of germ cells gives rise to the formation of this tumor.

• In general, it is known that cancers form when normal, healthy cells begin transforming into abnormal cells - these cancer cells grow and divide uncontrollably (and lose their ability to die), resulting in the formation of a mass or a tumor
• The transformation of normally healthy cells into cancerous cells may be the result of genetic mutations. Mutations allow the cancer cells to grow and multiply uncontrollably to form new cancer cells
• These tumors can invade nearby tissues and adjoining body organs, and even metastasize and spread to other regions of the body

What are the Signs and Symptoms of Dermoid Cyst of Ovary?

The signs and symptoms of Dermoid Cyst of Ovary can vary from one individual to another. In general, most (small) tumors are asymptomatic and no significant symptoms are observed, while large tumors are known to present symptoms.

The signs and symptoms of Dermoid Cyst of Ovary include the following:

• Presence of a well-circumscribed tumor mass in the ovary
• The tumor is cystic (fluid-filled) with varying tumor form/shape
• Generally, only one ovary is affected; but, in some cases, involvement of both ovaries may be seen (bilateral teratoma)
• The tumors may range in size from a few cm to over 10 cm
• Large tumors (size over 4 cm) can compress the surrounding structures or organs and give the sensation of an abdominal mass
• Abdominal pain from large-sized ovarian tumors
• Abdominal discomfort, heaviness, and tenderness (especially at the iliac fossa, which is an area near to the hip bone)
• Pelvic discomfort and pain; lower back pain
• Frequent urination due to compression/pressure of the tumor

How is Dermoid Cyst of Ovary Diagnosed?

There are a variety of tests the healthcare provider may employ to diagnose Dermoid Cyst of Ovary, which may include:

• Physical examination and complete medical history screening
• Assessment of the symptoms observed
• Blood tests for various markers
• Alpha fetoprotein (AFP) blood test
• Ultrasound scan of the pelvis: It is a non-invasive procedure that uses high frequency sound waves to produce real-time images
• Transvaginal ultrasound: An ultrasound is inserted into the vagina and the mass is examined using sound waves
• Abdominal and pelvic CT scan: It is a non-invasive procedure that provides more details of soft tissues, blood vessels, and internal organs
• Pelvic MRI scan: It is a non-invasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal structures of the abdomen and pelvis
• Hysteroscopy: This procedure involves placing a probe through the cervix to examine the cavity of the uterus

Invasive diagnostic procedures such as:

• Laparoscopy: A special device is inserted through a small hole into the abdomen, to visually examine it. If necessary, a tissue sample is obtained for further analysis. Exploration of the abdomen using a laparoscope is called ‘exploratory laparoscopy’
• Laparotomy: The abdomen is opened through an incision for examination, and if required, a biopsy sample obtained. Exploration of the abdomen using laparotomy procedure is called ‘exploratory laparotomy’

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include:

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
• Core biopsy of the tumor
• Open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• The tumors may have varying proportions of blood vessels, smooth muscle, and fat cells, when examined by a pathologist under a microscope
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Note: A differential diagnosis to eliminate other tumor types may be necessary prior to establishing a definite diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dermoid Cyst of Ovary?

The complications of Dermoid Cyst of Ovary may include the following:

• Stress and anxiety due to fear of cancer of the ovary
• Large tumor masses may get secondarily infected with bacteria or fungus
• Tumor rupture and torsion:
  • Rupture of tumor can cause peritonitis
  • Usually, larger tumors are more prone for torsion
  • Ovarian torsion can result in acute abdominal pain and a surgical emergency
• Occasionally, recurrence of the tumor following its incomplete surgical removal
• Some teratomas are known to transform to malignancies; the most common cancer arising from a mature cystic teratoma is squamous cell carcinoma
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Dermoid Cyst of Ovary Treated?

The treatment of Dermoid Cyst of Ovary may involve the following:

• In some case of small tumors (less than 4-6 cm), considering its slow-growing rate, the healthcare provider may consider conservative measures, instead of immediately recommending an invasive approach
• Generally, the treatment of choice is complete surgical excision for all teratomas (mature or immature). The following surgical procedures may be considered:
  • Operative laparoscopy
  • Cystectomy or surgical removal of the ovarian cyst
  • Oophorectomy or removal of the affected ovary
  • Ovarian tissue sparing techniques
• Additionally, chemotherapy and/or radiation therapy may be necessary for malignant teratomas
• Follow-up care with regular screening and check-ups are important and encouraged

How can Dermoid Cyst of Ovary be Prevented?

Currently, there are no known methods to prevent the development of Dermoid Cyst of Ovary.

What is the Prognosis of Dermoid Cyst of Ovary? (Outcome/Resolutions)

• The prognosis of Dermoid Cyst of Ovary is typically excellent with complete surgical removal of the tumor, since it is a benign tumor
• In case of a malignant transformation of a mature benign tumor to a cancerous teratoma, the prognosis depends on several factors including on the tumor stage

Additional and Relevant Useful Information for Dermoid Cyst of Ovary:

The following article link will help you understand other cancers and benign tumors:

http://www.dovemed.com/diseases-conditions/cancer/