Dermoid ovarian cyst: to remove or not

Cystic formations of the gonads are common gynecological diseases. Among all ovarian cysts, about 20% is a dermoid ovarian cyst, which by origin is not so much a cyst as a benign tumor. The disease is asymptomatic while the tumor is small, but as the formation grows (15 & ndash; 20 cm), the woman begins to worry about the severity or aching pain in the abdomen, disorders of the colon and bladder. Most often, this cyst is diagnosed in girls in puberty, young women and menopausal women.

Dermoid transformation into ovarian cancer is observed in 1 – 3% of situations. What is this cyst, how does it manifest itself, is it necessary to remove it – read on estet-portal.com.

What is a dermoid ovarian cyst

Other names for the tumor are mature teratoma (dermoid). Education is an additional section of the ovarian tissue, has a thick capsule filled with mucous contents. In the mucus of the cyst there are various inclusions: fat, hair, sections of bones, cartilage, teeth, and so on. More often the tumor is located on the right ovary, bilateral cysts are rarely formed. This formation can reach gigantic sizes, has a round or ovoid shape, a long leg. The presence of a stalk gives the cyst mobility, which is fraught with complications.

The origin of the dermoid ovarian cyst is due to a violation of the differentiation of ovarian tissue in the embryonic period. All 3 germ layers (endoderm, mesoderm, exoderm) are involved in the formation of the tumor. If the development of the fetus proceeds without deviations, then the layers do not remain in the future gonads. With a deviation from the normal course of embryogenesis, tissue differentiation is disturbed, and the cells of the embryonic layers are mixed. All of the above explains the mechanism of the formation of formation and the presence in it of components of various tissues formed from different embryonic layers.

The cyst begins to grow during periods of hormonal surges (puberty, pregnancy, perimenopause). Hormonal changes are not the cause, but the trigger for the onset of rapid tumor growth.

How does a dermoid ovarian cyst appear

A small size formation (up to 50 mm) does not manifest itself in any way, it can be detected by chance during a routine examination or during an ultrasound scan of the small pelvis. When the cyst reaches 100 – 150 mm, the patient begins to be disturbed by pressing and / or bursting pain in the lower abdomen, in some cases they are aching or pulling. There are problems with urination, defecation. With the pressure of a teratoma on the bladder, there is an imperative urge to urinate, as a result, it becomes frequent. Compression of the colon (in particular, the rectum) provokes the development of constipation, which are replaced by diarrhea and pain during defecation. Significant sizes of the formation lead to an increase, deformation of the abdomen, which is most noticeable in patients with asthenic physique. There may be pain during coitus and after it.<

Since teratoma is not considered a hormonally active tumor, its existence does not affect the regularity of the menstrual cycle, as well as the nature of menstruation. The presence of a long leg of the formation increases its mobility, which can provoke torsion of the leg with its further necrosis and the development of signs of an acute abdomen (hyperthermia, sharp abdominal pain, signs of peritoneal irritation). This situation requires immediate medical attention and removal of the cyst.

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Treatment measures for ovarian dermoid cyst

When a mass is detected, it is surgically removed, regardless of the presence or absence of symptoms and the size of the cyst. Firstly, the dermoid has a high risk of developing complications that require emergency surgical intervention (physical activity can provoke torsion of the teratoma stem or its rupture, the presence of chronic infectious foci in the body contributes to cyst suppuration). Secondly, teratoma has a minimal but risk of malignancy, especially in premenopausal women.

The amount of surgery is determined by a number of factors:•    presence or absence of complications;
•    age;
•    cyst size;
•    comorbid gynecological pathology;
•    the benign or malignant process.

In the case of an uncomplicated course of the dermoid and a young age, the patient undergoes excision of the cyst along the border of healthy tissues of the gonad or wedge-shaped resection of the ovary. In the event of complications or in the menopause, the removal of the ovary or appendages is performed. Operational access under favorable circumstances – laparoscopic. Laparotomy is indicated for suspected malignant teratoma or its complications.

Timely detected and operated ovarian dermoid cyst has a favorable prognosis both for the patient's reproductive health and for her life.