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Dermoid cyst

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Abino David
Abino David

Dermoid cysts are cysts lined with squamous epithelium that contain skin adnexa such as sweat glands, sebaceous glands, and hair follicles. There are several types of dermoid cysts including congenital dermoid cysts that form along embryonic fusion lines and can cause bony defects, implantation dermoid cysts that form after skin implantation injuries, and teratomatous dermoid cysts containing tissues from all germ layers. Dermoid cysts typically present as slow-growing, painless swellings and are diagnosed based on location and imaging findings showing cystic masses sometimes eroding adjacent bone. Excision is the treatment.

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DERMOID CYST
 Cyst lined by squamous epithelium containing desquamated cells  CONTENTS mixture of sweat, sebum, desquamated epithelial cells, hair
CLINICAL TYPES  CONGENITAL / SEQUESTRATION DERMOID SITE: along lines of embryonic fusion (midline of body or face) FORMATION: dermal cells sequestrated in subcutaneous plane > proliferate & liquify > cyst > grows & indents mesoderm(future bone) > bony defects
 MEDIAL NASAL DERMOID CYST (root of nose at fusion lines of frontal process)  EXTERNAL AND INTERNAL ANGULAR DERMOID ( fusion line of frontonasal and maxillary processes)  SUBLINGUAL DERMOID  PRE –AURICULAR DERMOID  POST AURICULAR DERMOID
Dermoid cyst
CLINICAL FEATURES  Manifests in childhood or adolescence  Typically a painless slow growing swelling  Soft, cystic, fluctuant, yield to pressure of finger and will not slip away  Transillumination negative  Putty in consistency  No impulse on coughing  Underlying bony defect – clue to diagnosis  Location along line of fusion
Dermoid cyst
OTHER TYPES  IMPLANTATION DERMOID > in women, tailors, agriculturists who sustain repeated minor injuries > sharp injury- epidermal cells implanted in subcutaneous plane- dermoid cyst > fingers, palm, sole of foot > hard in consistency ( skin is thick)
 TERATOMATOUS DERMOID > arise from totipotent cells > ectodermal, mesodermal, endodermal elements > ovary, testis,retroperitoneum, mediastinum
Dermoid cyst
 TUBULO-EMBRYONIC DERMOID > from ectodermal tubes > thyroglossal cyst, post- anal dermoid
INVESTIGATIONS  BLOOD – TC, DC,Hb,ESR  URINE Examination  FNAC-  X ray- subjacent bone eroded by dermoid  Ultrasonography- mass cystic/ solid  CT scan- size , shape , local spread
TREATMENT  Excision of the cyst Mass shown ( implantation dermoid) Incision marked
Incision started ( cyst contents leaking) cyst being removed
Dermoid cyst
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Dermoid cyst

  • 2.  Cyst lined by squamous epithelium containing desquamated cells  CONTENTS mixture of sweat, sebum, desquamated epithelial cells, hair
  • 3. CLINICAL TYPES  CONGENITAL / SEQUESTRATION DERMOID SITE: along lines of embryonic fusion (midline of body or face) FORMATION: dermal cells sequestrated in subcutaneous plane > proliferate & liquify > cyst > grows & indents mesoderm(future bone) > bony defects
  • 4.  MEDIAL NASAL DERMOID CYST (root of nose at fusion lines of frontal process)  EXTERNAL AND INTERNAL ANGULAR DERMOID ( fusion line of frontonasal and maxillary processes)  SUBLINGUAL DERMOID  PRE –AURICULAR DERMOID  POST AURICULAR DERMOID
  • 6. CLINICAL FEATURES  Manifests in childhood or adolescence  Typically a painless slow growing swelling  Soft, cystic, fluctuant, yield to pressure of finger and will not slip away  Transillumination negative  Putty in consistency  No impulse on coughing  Underlying bony defect – clue to diagnosis  Location along line of fusion
  • 8. OTHER TYPES  IMPLANTATION DERMOID > in women, tailors, agriculturists who sustain repeated minor injuries > sharp injury- epidermal cells implanted in subcutaneous plane- dermoid cyst > fingers, palm, sole of foot > hard in consistency ( skin is thick)
  • 9.  TERATOMATOUS DERMOID > arise from totipotent cells > ectodermal, mesodermal, endodermal elements > ovary, testis,retroperitoneum, mediastinum
  • 11.  TUBULO-EMBRYONIC DERMOID > from ectodermal tubes > thyroglossal cyst, post- anal dermoid
  • 12. INVESTIGATIONS  BLOOD – TC, DC,Hb,ESR  URINE Examination  FNAC-  X ray- subjacent bone eroded by dermoid  Ultrasonography- mass cystic/ solid  CT scan- size , shape , local spread
  • 13. TREATMENT  Excision of the cyst Mass shown ( implantation dermoid) Incision marked
  • 14. Incision started ( cyst contents leaking) cyst being removed