It’s one of those moments that can send a little shiver of worry down your spine. You’re gently stroking your child’s face, or maybe you’re just looking in the mirror one day, and you notice it – a small, firm lump under the skin. Your mind might race a bit. What could it be? Well, sometimes, it turns out to be something called a dermoid cyst.
I know, “cyst” can sound a bit alarming, but let’s talk about what these actually are. Think of a dermoid cyst as a little pocket, a sac, that formed before birth, while you or your little one was still developing. Inside this sac, instead of just fluid, there’s normal tissue that just happens to be in an unexpected spot. “Dermoid” just means it’s like skin. Most of the time, these cysts are perfectly harmless, just a bit… out of place.
So, What Exactly Is a Dermoid Cyst?
Alright, let’s break it down. A dermoid cyst is a growth, but it’s not usually the scary kind. It’s made of normal tissue that’s enclosed in this sac. Because it’s made of tissue that belongs elsewhere, you might find some surprising things inside if we were to look:
- A greasy, yellowish material (this is pretty common)
- Sometimes, bits of hair
- Even tiny bits of bone or teeth!
- Skin cells, sweat glands, or nerves
- Fluid
Weird, right? These cysts can pop up anywhere on the body. If they’re close to the surface, they often just look like a small, roundish lump. But they can also develop deeper inside. The good news is, they generally aren’t cancerous. They won’t go away on their own, though, so sometimes we need to talk about removing them.
Where Do These Cysts Usually Show Up?
Dermoid cysts can appear in various places, but some spots are more common than others.
- Periorbital dermoid cyst: This is a very common one, especially in little ones. You’ll usually find it near the outer edge of an eyebrow. I’ve seen many parents come in worried about a little bump there.
- Ovarian dermoid cyst: These, as the name suggests, form on or in an ovary.
- Spinal dermoid cyst: Less common, these form on the spine.
There are even rarer types, like those on the eye surface (epibulbar), in the brain (intracranial), inside the nose (nasal sinus), or around the eye socket bones (orbital).
Most of these – more than eight out of ten, actually – are found on the head and neck. And it’s interesting, about seven out of ten dermoid cysts are spotted in kids under five, with a good chunk, around four out of ten, noticed right at birth. So, if you’re a parent who’s just found one, you’re definitely not the first.
What Makes a Dermoid Cyst Form?
This is something that happens way back, during fetal development – when a baby is growing in the uterus. They are congenital, meaning present from birth.
Essentially, as the skin layers are forming, sometimes they don’t quite fuse together perfectly. When this happens, some skin cells, tissues, and glands that should be on the outside can get trapped inside, forming that little sac. And because things like sweat glands might be in there, they keep doing their job, producing fluids, which can sometimes make the cyst grow a bit over time.
What Might You Notice? Signs and Symptoms
Often, a dermoid cyst doesn’t cause any trouble at all. You might not even know it’s there unless it’s visible or grows. If symptoms do pop up, they really depend on where the cyst is and how big it’s gotten.
- Periorbital dermoid cyst (near the eyebrow):
- A noticeable lump, maybe a bit swollen.
- It might have a slightly yellowish look to it.
- If it gets bigger, it could even start to change the shape of the nearby bone a little.
- Ovarian dermoid cyst:
- You might feel some pain in your pelvic area. This can be more noticeable around your period.
- Spinal dermoid cyst: This one can be a bit more tricky if it grows.
- It can press on the spinal cord or nerves, leading to:
- Trouble walking.
- Urinary incontinence (losing control of your bladder).
- Weakness in your legs or arms.
How Do We Figure Out If It’s a Dermoid Cyst?
When you come in, the first thing I’ll do is listen. I’ll ask about any symptoms you or your child have been experiencing. Then, how we diagnose it depends on where we suspect the dermoid cyst might be:
- Physical exam: If the cyst is right under the skin, like those eyebrow ones, I can often get a good idea just by feeling it and looking at the area.
- CT (computed tomography) scan or MRI (magnetic resonance imaging): These are fancy imaging tests, but they’re noninvasive and give us a really good look inside. They can show us exactly where the cyst is, if it’s near anything delicate (like an artery or a nerve, especially with spinal cysts), and help us plan if it needs to come out.
- Pelvic ultrasound or transvaginal ultrasound: If we’re thinking about an ovarian dermoid cyst, these are the go-to. An ultrasound uses sound waves – totally painless – to create pictures. For a pelvic ultrasound, we’ll use a probe on your belly. For a transvaginal ultrasound, a slim wand is gently inserted into the vagina for a closer look.
Getting Rid of a Dermoid Cyst: Treatment Options
Here’s the straightforward bit: the only way to truly get rid of a dermoid cyst is with surgical removal. The type of surgery really depends on the cyst’s location and size.
- Periorbital dermoid cyst: This is usually a pretty simple procedure. We’ll clean the area, numb it up with a local anesthetic (so you or your child won’t feel pain there), and then make a small incision to remove the cyst. We’ll use tiny stitches to close it up, aiming for minimal scarring.
- Ovarian dermoid cyst: Often, we can use minimally invasive surgery, something called an ovarian cystectomy. The goal here is to remove the cyst without having to remove the whole ovary. If the cyst is very large or complicated, sometimes removing the ovary along with the cyst is necessary.
- Spinal dermoid cyst: This is more delicate. Surgeons use a special surgical microscope and very precise tools – it’s called microsurgery. You’d be asleep under general anesthesia for this, lying face down so the surgeon can access the spine carefully.
What to Expect and Potential Hiccups
Most of the time, if left alone, a dermoid cyst won’t cause major harm. But, and this is an important “but,” if they grow, they can sometimes lead to complications. These can include:
- Damage to nearby bones.
- Infection (the cyst can get inflamed and sore).
- For spinal cysts, injury to the spinal cord or nerves.
- Rupture (the cyst bursting open).
- For ovarian cysts, a painful twisting of the ovary called ovarian torsion.
Surgery to remove a dermoid cyst is generally very safe. Getting it removed can help with any symptoms and, importantly, prevent these future complications. If you’re dealing with an ovarian dermoid cyst and thinking about surgery, it’s a good idea to chat with your doctor about how it might affect fertility – just so you have all the information.
Can You Prevent Dermoid Cysts?
Since dermoid cysts are congenital – meaning they form before birth – there’s nothing you can do to prevent them or reduce the chances of one developing. It’s just one of those things that happens sometimes during early development.
When Should You Ring Your Doctor?
If you or your child has a lump, it’s always a good idea to get it checked out. Definitely see your provider if you notice any new symptoms, or if existing ones get worse. And seek medical attention right away if a cyst:
- Suddenly becomes very inflamed or red.
- Starts to cause pain.
- Changes color or seems to be getting bigger quickly.
- Ruptures or leaks.
Questions You Might Want to Ask Your Doctor
It’s your health (or your child’s), so asking questions is key! You might consider these:
- What’s the best way to treat this specific dermoid cyst?
- Is there a chance the cyst could come back after it’s removed?
- What will recovery be like after the surgery?
Take-Home Message: Key Things to Remember About Dermoid Cysts
Let’s quickly recap the main points about a dermoid cyst:
- It’s a sac-like growth present from birth, containing normal tissues like skin, hair, or even teeth, but in an unusual place.
- They are usually benign (not cancerous) and often don’t cause symptoms unless they grow or are in a sensitive area.
- Common spots include near the eyebrows (periorbital), on the ovaries, or on the spine.
- Diagnosis often involves a physical exam, and sometimes imaging like CT, MRI, or ultrasound.
- The only treatment is surgical removal, with the type of surgery depending on the cyst’s location.
- While often harmless, they can sometimes lead to complications like infection or damage to nearby structures if not monitored or removed.
Finding a lump can be unsettling, that’s for sure. But understanding what it might be, like a dermoid cyst, is the first step. We’re here to help figure things out and decide on the best path forward. You’re not alone in this.
