It’s not every day that a routine scan turns up something unexpected, is it? I’ve sat with many women who’ve come in for, say, a pregnancy ultrasound, and there on the screen, separate from the little one, is something else. A little blip. Sometimes, that blip turns out to be an Ovarian Dermoid Cyst. The name itself can sound a bit alarming, I know. But let’s chat about what this actually means, because often, it’s not as scary as it sounds.
So, What Exactly Is an Ovarian Dermoid Cyst?
Alright, let’s break it down. An Ovarian Dermoid Cyst is essentially a sac, usually filled with fluid, that forms on or in an ovary. What makes these cysts a bit, well, unique is what’s inside. They can contain bits of fully developed tissue – things like hair, skin, sometimes even tiny tooth-like structures or bits of nerve tissue. It’s a bit like a tiny collection of body parts that ended up where they weren’t “supposed” to be.
Now, these aren’t the common ovarian cysts that pop up and disappear with your monthly cycle. Nosiree. These are different. They’re technically a type of germ cell tumor, and another name you might hear for them is a mature cystic teratoma. Sounds complex, but “mature” just means the tissues inside are well-developed, not cancerous, and “teratoma” is the medical term for these kinds of mixed-tissue growths. The good news? The vast majority of these are benign, meaning they’re not cancerous.
Who Gets These Cysts, and How Common Are They?
Honestly, anyone with ovaries can develop an Ovarian Dermoid Cyst. They’re actually thought to be present from birth, tucked away, and often they’re only discovered by chance, maybe during an imaging test for something else entirely. It’s not at all unusual, for instance, to find one during a pregnancy ultrasound, like I mentioned.
They are the most common type of benign (non-cancerous) ovarian germ cell tumor. And, they’re the most frequent type of ovarian tumor we find during pregnancy – about a third of all benign tumors diagnosed then are these dermoid cysts. Sometimes, in about 10% to 15% of cases, they can show up in both ovaries.
How Might an Ovarian Dermoid Cyst Affect Me?
Most of the time, these cysts just sit there quietly and don’t cause any trouble. The concern comes if they grow quite large. Bigger cysts have a higher chance of causing a couple of specific problems:
- Ovarian Torsion: This is when the cyst gets so heavy it causes the ovary to twist on itself. Imagine a heavy apple on a thin branch, causing it to rotate. This twisting can cut off blood supply to the ovary, which can damage it or even cause it to die if not treated quickly. It’s a painful emergency.
- Rupture: Though less common, a cyst can burst, leaking its contents into your abdomen. Often, your body can absorb this without a fuss. But sometimes, a rupture can lead to an infection and will need urgent medical attention.
The chance of an Ovarian Dermoid Cyst becoming cancerous is very low, less than 2%. The risk might be a tiny bit higher if you’re over 45, if the tumor is growing really fast, or if it’s larger than 10 centimeters (about 4 inches). If there’s any worry about these things, we’d definitely talk about removing it.
Telltale Signs (Or Lack Thereof)
Here’s the thing: most Ovarian Dermoid Cysts are silent lurkers. You might not even know you have one unless it gets pretty big. If symptoms do pop up, they’re often a bit vague:
- A dull ache or pain in your lower belly.
- A feeling of pressure or fullness down there.
Less commonly, you might experience:
- Nausea or even vomiting.
- Constipation.
- Changes in your appetite.
- Pain during intercourse (we call this dyspareunia).
What’s the Story Behind These Cysts?
This is where it gets a bit fascinating, medically speaking. Ovarian Dermoid Cysts actually start forming before you’re even born. They come from germ cells – these are the very basic cells that, in normal development, would go on to become eggs (or sperm in males).
During early development, these germ cells have three main layers, each destined to form different parts of the body:
- Ectoderm: Becomes skin, hair, sweat glands, teeth.
- Mesoderm: Forms muscle and connective tissue.
- Endoderm: Develops into the gut and various internal organs.
With a dermoid cyst, some of these germ cells grow a bit atypically. Instead of spreading out to do their jobs, mature tissues from these layers – like skin, fully formed hair, teeth, nerve tissue, even bits of brain tissue – get bundled together inside the ovary, forming the cyst. Weird, right?
The tissue from sweat glands inside the cyst can also secrete an oily fluid called sebum, and this can cause the cyst to grow slowly over time, with most growth happening during your reproductive years.
Finding Out: How We Diagnose Them
Since they’re often symptom-free, you’ll most likely find out you have an Ovarian Dermoid Cyst during an imaging test done for another reason.
- An ultrasound, either over your abdomen or a transvaginal one (where a small probe is gently inserted into the vagina), is usually how we spot them. These cysts have a pretty distinctive look on ultrasound, so experienced sonographers (the specialists who perform and interpret ultrasound images) can identify them with near 100% accuracy. They can often see the different types of tissues inside.
- Less often, if the ultrasound isn’t completely clear, an MRI (Magnetic Resonance Imaging) scan might be used. An MRI can give us an even more detailed picture of what the cyst is made of.
##Okay, I Have One. What’s Next for Treatment?
Finding out you have an Ovarian Dermoid Cyst naturally leads to the question: does it need to come out? Not always. If it’s small, not causing symptoms, and doesn’t look worrying, we might just decide to keep an eye on it with regular check-ups and maybe repeat ultrasounds.
However, we might recommend removing it if:
- It’s large (usually bigger than about 5 centimeters, or 2 inches, in diameter).
- It’s causing you pain or other symptoms.
- There’s any concern it might twist, rupture, or (very rarely) be malignant.
One thing to know is that these cysts don’t go away on their own. Unlike some other types of ovarian cysts that can resolve spontaneously, dermoid cysts will stay put unless they’re surgically removed.
If removal is the best course, the main goal is to take out the cyst while preserving your ovary and your fertility, especially if you’re planning to have children. The common surgical options are:
- Ovarian Cystectomy: This is where we carefully remove just the cyst, leaving the healthy part of your ovary intact. This is often the preferred method to preserve fertility.
- Oophorectomy: In some cases, especially if the cyst is very large or there are other concerns, we might need to remove the entire ovary that contains the cyst.
Most of these surgeries can be done using laparoscopy, which you might know as “keyhole surgery.” This involves a few tiny cuts in your abdomen, through which a camera and small instruments are inserted. It usually means a quicker recovery. If the cyst is exceptionally large, if you have cysts on both ovaries, or if there’s a higher suspicion of malignancy, a laparotomy might be needed. This involves a larger incision in your abdomen.
We’ll always sit down and discuss all the options thoroughly, making sure the plan is right for you and your specific situation.
What to Expect if You Have an Ovarian Dermoid Cyst
If we find an Ovarian Dermoid Cyst, the first step is not to panic. If it’s small and not causing issues, we might just monitor it. If it’s larger or causing symptoms, or if there are any concerns about torsion, rupture, or (rarely) cancer, then surgery to remove it is usually recommended.
The good news is that surgery is generally very effective. The chances of an Ovarian Dermoid Cyst growing back after it’s been removed are quite low, only about 3% to 4% of the time.
And no, just to be absolutely clear, an ovarian dermoid cyst is not a baby. It’s a collection of mature tissues that formed in an unusual way.
Can I Prevent Ovarian Dermoid Cysts?
Unfortunately, no. Since these cysts form before you’re even born, there’s nothing you can do to prevent them from developing.
When Should I Ring the Doctor Urgently?
While we might be monitoring a known cyst, or even after you’ve had one treated, it’s important to know the warning signs that something might be wrong, like a rupture or ovarian torsion. Get in touch with your doctor or seek medical attention right away if you experience:
- Sudden, severe, or excruciating pain in your abdomen (often on one side, but not always).
- Nausea and vomiting along with the pain.
- Feeling very dizzy or lightheaded.
- Unexpected vaginal bleeding.
- Fever.
These could be signs that the cyst has twisted or ruptured, and that needs prompt attention.
Key Takeaways on Ovarian Dermoid Cysts
Let’s quickly recap the main points about an Ovarian Dermoid Cyst:
- It’s a non-cancerous (benign) growth on the ovary, present from birth, containing various mature tissues like hair or skin.
- Often found by chance during imaging tests, as they frequently don’t cause symptoms.
- If symptoms occur, they might include pelvic pain or pressure.
- Major concerns are ovarian torsion (twisting) or rupture, though rare. Malignancy is very rare.
- Diagnosis is usually via ultrasound.
- Treatment isn’t always needed. If it is, surgery (often laparoscopic cystectomy) can remove the cyst, usually preserving the ovary.
- You can’t prevent them, but the outlook is generally very good.
A Final Thought
Hearing you have any kind of cyst can be unsettling, I completely understand. But when it comes to an Ovarian Dermoid Cyst, remember that they are common, usually harmless, and we have very good ways of managing them. We’ll work through it together, every step of the way. You’re not alone in this.