Maxillofacial

dermoid cyst
Mohammadreza norouzi
418 I 2a
A dermoid cyst is a saclike growth that is present at birth.
It contains structures such as hair, fluid, teeth, or skin
glands that can be found on or in the skin.
Dermoid cysts grow slowly and are not tender unless
ruptured. They usually occur on the face, inside the skull,
on the lower back, and in the ovaries. Superficial
dermoid cysts on the face usually can be removed
without complications. Removal of other, more rare
dermoid cysts requires special techniques and training
These rarer dermoid cysts occur in four major areas:
•Dermoid cysts in the brain: Dermoid cysts occur very rarely here. A neurosurgeon may
need to remove them if they cause problems.
•Dermoid cysts in the nasal sinuses: These are also very rare. Only a handful of cases
involving dermoid cysts located here are reported each year. Removal of these cysts is
extremely complicated.
•Ovarian dermoid cysts: These growths can develop in a woman during their reproductive
years. They can cause torsion, infection, rupture, and cancer. These dermoid cysts can be
removed with either conventional surgery or laparoscopy (surgery that uses small
incisions and specially designed instruments to enter the abdomen or pelvis).
•Dermoid cysts of the spinal cord: A sinus tract, which is a narrow connection from a deep
pit in the skin, usually connects these very rare cysts to the skin surface. This type of
dermoid cyst can become infected. Removal is often incomplete, but the outcome is
usually excellent.
Dermoid Cyst Causes
Dermoid cysts are caused when skin and skin structures
become trapped during fetal development. Their cell
walls are nearly identical to those of the outer skin and
may contain multiple skin structures such as hair follicles,
sweat glands, and sometimes hair, teeth, or nerves.
When to Seek Medical Care
A doctor should be contacted in the following situations:
•A cyst becomes painful or inflamed.
•A cyst grows or changes color.
•Removal is desired for cosmetic reasons.

Typically, removing a dermoid cyst is not an emergency procedure. If a

dermoid cyst ruptures, becomes inflamed, or causes pain or fever, a person
should seek immediate medical advice. Depending on the severity of pain
or discomfort, a person might also consider visiting a hospital’s emergency
department.
Exams and Tests for Dermoid Cysts
Prior to removal of superficial dermoid cysts on the face, a person should know
the difference between cysts and other facial growths.
•Because dermoid cysts stem from birth and grow slowly, a person usually notices
them during childhood or early adulthood.
•Dermoid cysts are firm and painless unless ruptured.
•Dermoid cysts are not attached to the overlying skin.
In rare cases, a dermoid cyst extends into a structure deeper than skin, such as a
facial cavity or an orbit. Some doctors recommend a CT scan or other imaging
studies for these cases. This decision depends on the doctor’s suspicion of a
deep-level cyst and after a determination of risk versus benefit.
Dermoid Cyst Home Remedies
Self-removal of facial cysts at home is not recommended, because
the cyst will grow back if not completely removed. Chances of
infection, bleeding, and other complications increase for people who
remove dermoid cysts themselves, especially because the person
may not be able to differentiate between a harmless growth and
other, more serious skin growths.
Medical Treatment for Dermoid Cysts
To remove a dermoid cyst, the doctor will clean the area over which
the cyst is located, inject a local anesthetic, and make an incision
directly over the cyst and attempt remove it completely.
 • How serious is a dermoid cyst?
• Dermoid cysts are usually
harmless, but some may cause
• Is a dermoid cyst a baby?
complications depending on their
• A dermoid cyst is present from size and location. If you or your
birth. It happens when the skin child has a dermoid cyst, talk to
layers don't grow together as your healthcare provider about the
they should. This happens during best ways to treat it. Your provider
a baby's development in the can often remove a dermoid cyst
uterus. They are often found on through surgery.
the head, neck, or face.
Is a dermoid a cyst or tumor?
Dermoid cysts are benign (not cancer) and tend to grow slowly. They are
present at birth but may not be found until later in life. Dermoid cysts are a
type of germ cell tumor called a mature teratoma

• Why is there hair and teeth in a cyst?

• Dermoid Cyst Causes

Dermoid cysts are caused when skin

and skin structures become trapped
during fetal development. Their cell
walls are nearly identical to those of
the outer skin and may contain
multiple skin structures such as hair
follicles, sweat glands, and
sometimes hair, teeth, or nerves
A dermoid cyst is a teratoma of a cystic nature that contains an array
of developmentally mature, solid tissues. It frequently consists of skin,
hair follicles, and sweat glands, while other commonly found
components include clumps of long hair, pockets of sebum, blood, fat,
bone, nail, teeth, eyes, cartilage, and thyroid tissue.
As dermoid cysts grow slowly and contain mature tissue, this type of
cystic teratoma is nearly always benign. In those rare cases wherein
the dermoid cyst is malignant, a squamous cell carcinoma usually
develops in adults, while infants and children usually present with
Periorbital dermoid cysts[edit]
Dermoid cysts can appear in young children, often near the lateral aspect of the eyebrow (right part of
the right eyebrow or left part of the left eyebrow). Depending on the perceived amount of risk, these are
sometimes excised or simply kept under observation.
An inflammatory reaction can occur if a dermoid cyst is disrupted, and the cyst can recur if it is not
completely excised. Sometimes complete excision is not practical if the cyst is in a dumbbell
configuration, whereby it extends through a suture line in the skull.
If dermoid cysts appear on the medial aspect, the possibility of an encephalocele becomes greater and
should be considered among the differential diagnoses.
Other areas where a dermoid cyst may appear are the brain, scrotum and the pharynx.
Dermoid cysts develop during pregnancy. They occur when skin cells and things like hair, sweat glands,
oil glands or fatty tissue get trapped in the skin as a baby grows in the womb. Dermoid cysts are
present at birth (congenital) and are common. It can be months or years before a dermoid cyst is
noticed on a child because the cysts grow slowly.
Dermoid cyst symptoms are minor and the cysts are usually painless. They are not harmful to a child's
health. If they become infected, the infection must be treated and the cyst should be removed. It is
easier to remove cysts and prevent scars if the cyst is removed before it gets infected
pinal dermoid cysts[edit]
Spinal dermoid cysts are benign ectopic growths thought to be a consequence of embryology errors
during neural tube closure. Their reported incidence is extremely rare, accounting for less than 1% of
intramedullary spinal cord tumours. It has been proposed that a possible 180 cases of spinal
dermoid tumours have been identified over the past century in the literature.[8][9]
Dermoid cysts more often involve the lumbosacral region than the thoracic vertebrae and are
extramedullary presenting in the first decade of life.
Various hypotheses have been advanced to explain the pathogenesis of spinal dermoids, the origin
of which may be acquired or congenital.
•Acquired or iatrogenic dermoids may arise from the implantation of epidermal tissue into the
subdural space i.e. spinal cutaneous inclusion, during needle puncture (e.g. lumbar puncture) or
during surgical procedures on closure of a dysraphic malformation.[9][10]
•Congenital dermoids, however, are thought to arise from cells whose position is correct but which
fail to differentiate into the correct cell-type. The long-time held belief was that the inclusion of
cutaneous ectodermal cells occurred early in embryonic life, and the displaced pluripotent cells
developed into a dermoid lesion.[10][11]
Spinal abnormalities, e.g. intramedullary dermoid cysts may arise more frequently in the lumbosacral
region (quite often at the level of the conus medullaris) and may be seen with other congenital
anomalies of the spine including posterior spina bifida occulta as identified by the neuroradiological
analysis
Treatment
Treatment for dermoid cyst is complete surgical removal, preferably in one piece
and without any spillage of cyst contents. Marsupialization, a surgical technique
often used to treat pilonidal cyst, is inappropriate for dermoid cyst due to the risk of
malignancy.
The association of dermoid cysts with pregnancy has been increasingly reported.
They usually present the dilemma of weighing the risks of surgery and anesthesia
versus the risks of untreated adnexal mass. Most references state that it is more
feasible to treat bilateral dermoid cysts of the ovaries discovered during pregnancy
if they grow beyond 6 cm in diameter.