Dermoid cyst Management

Dermoid cyst

Dermoid cyst is a congenital benign cystic lesion that develops due to sequestration of ectodermal tissue during embryonic development. It contains skin structures such as hair follicles, sebaceous glands, and sweat glands and may also contain hair and sebaceous material.

Dermoid cysts are usually diagnosed during childhood or early adulthood and commonly occur near the eyebrows, orbit, nose, scalp, and midline of the neck.

Pathophysiology (Brief)

Dermoid cysts result from entrapment of ectodermal tissue during embryonic fusion.

The cyst wall contains mature skin appendages, which continue producing keratin and sebaceous material, causing gradual enlargement.

Signs & Symptoms

Typical lesions include:

• Slow-growing painless mass

• Firm, well-defined cyst

• Smooth surface

• Mobile unless attached to deeper tissues

Common sites:

• Lateral eyebrow

• Periorbital region

• Nose

• Scalp

• Midline neck

Other findings:

• Present since birth or early childhood

• Usually asymptomatic

Diagnostic Criteria

Diagnosis is based on:

• Congenital slow-growing cyst

• Typical anatomical location

• Characteristic clinical appearance

Investigations

Recommended investigations

Diagnosis is usually clinical.

Special investigations

• Ultrasound

• CT scan or MRI if deep extension is suspected, especially around the orbit or midline lesions.

• Histopathological examination following excision.

Treatment

Non-pharmacological Treatment

• Observation may be appropriate for selected asymptomatic lesions while awaiting surgery.

• Avoid trauma to the cyst.

Surgical treatment

Complete surgical excision of the cyst without rupture.

Complications

• Secondary infection

• Rupture

• Cosmetic deformity

• Local recurrence after incomplete excision

Prevention

Dermoid cysts are congenital and cannot be prevented.

Early diagnosis and complete excision reduce complications.Patient counselling (Important)

• Dermoid cysts are benign congenital lesions.

• They are not contagious and are not cancerous.

• Complete surgical excision is usually curative.

• Seek medical review if the cyst enlarges rapidly, becomes painful, or develops signs of infection.