Dermoid cyst

Dear Alice,

What is the name of the cyst that when removed is made of hair and teeth and body tissue? My friend had one removed from her ovary and her doctor said that very few of them are malignant.

Dear Reader,

You could be describing a dermoid cyst. Dermoid cysts are benign tumors that contain nails, teeth, bone, hair, cartilage, or other tissues, and can be filled with a fatty substance. They vary in size and location, generally appearing on an ovary, as in your friend's situation. In 25 percent of cases, cysts are found on both ovaries. Dermoid cysts may also occur in other parts of the body, such as the lungs, skin, spine, abdomen, or even skull. Depending on the location in the body, they are common to rare. Anyone at any age can have a dermoid.

Dermoid cysts of the ovary are fairly common and most often affect young females around the age of 30. They are often discovered during a routine pelvic exam, as they generally cause no symptoms. Surgical removal is usually recommended and laparoscopic surgery is the preferred method, if the cyst is small. This procedure involves inserting a tiny scope into small cuts in the abdomen and filling the abdomen with air, which allows room to maneuver. The surgeon then dissects and removes the cyst. If the dermoid is especially large, the surgeon makes a bigger incision into the abdomen. Planned, rather than emergency, surgery can prevent complications, such as twisting of the cyst, lower abdominal pain, rupture of the cyst, and infection. The cyst is typically on the surface of the ovary or at the end of a pedicle or stalk, making its removal relatively simple. In females of reproductive age, the goal of treatment is to preserve all or part of the ovary.

Depending on the position of the cyst within the ovary, it may be necessary to remove a portion of or the entire ovary. In this case, there may be a concern about fertility potential. If the remaining ovarian tissue is normal, ovulation, menstruation, and conception are all still possible. Even if one ovary is completely removed, the other ovary is stimulated and continues to produce eggs, so that conception can occur.

Though extremely rare, one to three percent of dermoid cysts of the ovary become cancerous. Most of the cysts that undergo malignant degeneration occur in those who are postmenopausal. Prognosis depends on cancer cell type, stage of cancer, and success of the cancer treatment.

Talking with the surgeon before the operation is an critical part of planning for the future. It's a good idea to identify and write down any questions, and then be sure to understand the answers. Seeking a second opinion before surgery is an appropriate option. Lastly, bringing a companion can be helpful, since it is difficult to absorb and retain unfamiliar information under stressful circumstances.

Last updated May 27, 2015
Originally published Feb 06, 2004

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