Ovarian Dermoid Cyst

What is an ovarian dermoid cyst?

An ovarian dermoid cyst is a fluid-filled sac containing tissue from your hair, skin, teeth or other body parts. Unlike most ovarian cysts, dermoid cysts don’t form in response to your menstrual cycle. Instead, like other dermoid cysts, they form when fully developed tissue collects in an odd location (like in your ovaries).

Ovarian dermoid cysts aren’t cancerous, but they can cause complications if they grow too large. a healthcare provider can evaluate your cyst and advise on whether to remove it.

Ovarian dermoid cysts are sometimes called mature cystic teratomas.

Who is affected by ovarian dermoid cysts?

Anyone with ovaries can develop an ovarian dermoid cyst. They’re likely present at birth, but they’re usually not discovered until a routine imaging procedure. It’s not uncommon, for instance, to learn during a pregnancy ultrasound that you have this type of cyst.

How common are ovarian dermoid cysts?

Ovarian dermoid cysts are the most common type of benign ovarian germ cell tumor. They’re the most common type of ovarian tumor found during pregnancy. About one-third of all benign tumors diagnosed during pregnancy are ovarian dermoid cysts. They appear in both ovaries in 10% to 15% of cases.

How do ovarian dermoid cysts affect my body?

Ovarian dermoid cysts become concerning if they cause complications. The bigger they are, the more likely they are to cause problems. Complications include:

• Ovarian torsion: Ovarian dermoid cysts can grow so large that they cause the affected ovary to twist out of shape. Without treatment, the twisting can harm the ovary or cause it to die.
• Rupture: These cysts can burst, leaking their contents into your abdominal cavity. Often, your body absorbs the contents of ruptured cysts with no problem. Sometimes, ruptured cysts lead to infection and require emergency medical attention.

Ovarian dermoid cysts become cancerous in less than 2% of cases. There’s a greater risk of your tumor becoming cancer if:

• You’re over 45.
• Your tumor is growing rapidly.
• Your tumor has a diameter that’s greater than 10 centimeters.

Your provider can remove your cyst if there’s a concern that it could rupture, twist or become cancerous.

What are the symptoms of an ovarian dermoid cyst?

Most ovarian dermoid cysts don’t cause symptoms unless they’re especially large. If you do notice symptoms, they’ll likely include pain, pressure or a feeling of fullness in your abdomen.

Less often, symptoms of an ovarian dermoid cyst include:

• Nausea.
• Vomiting.
• Constipation.
• Changes to your appetite.
• Painful intercourse (dyspareunia).

What causes an ovarian dermoid cyst?

Ovarian dermoid cysts form before you’re born. Some of the cells that eventually become skin, hair, nervous system, etc., grow atypically with dermoid cysts. Scientists aren’t sure what triggers the atypical growth. The cells develop into mature tissue, such as fully formed skin, hair, teeth, nerves and even brain tissue. This hodgepodge tissue collects, creating a benign mass inside of your ovaries.

Tissue from sweat glands can form inside of the cyst, too. These glands secrete an oily fluid called sebum that causes your cyst to grow. Dermoid cysts grow slowly, with most growth happening during your reproductive years.

Why do dermoid cysts have hair and teeth?

Dermoid cysts form from germ cells, the cells that eventually become egg or sperm cells. Germ cells have three layers that grow into tissues, organs and body systems during fetal development:

• Ectoderm, eventually becomes skin, hair, sweat glands and teeth.
• Mesoderm, eventually becomes muscle and connective tissue.
• Endoderm, eventually becomes the gut and various internal organs.

Sometimes, these layers grow atypically, with mature tissue bunching together to form a dermoid cyst. The cyst may contain hair and teeth, but it may also include tissue that arises from any of the three layers that make up a germ cell.

How is it diagnosed?

As ovarian dermoid cysts don’t often cause symptoms, you’ll likely learn that you have one during a routine imaging procedure. Your provider may find one during an abdominal or transvaginal ultrasound. Dermoid cysts have a distinctive appearance that makes them easy to identify with imaging. Experienced sonographers (specialists who interpret ultrasound images) can identify dermoid cysts nearly 100% of the time.

Less often, magnetic resonance imaging (MRI) is used to identify ovarian dermoid cysts. An MRI can offer additional insight into the make-up of a cyst if an ultrasound doesn’t provide enough information.

Do ovarian dermoid cysts need to be removed?

Not all ovarian dermoid cysts need to be removed. Your provider may recommend removing your cyst if it’s gotten large (approximately greater than 5 centimeters in diameter), if it’s causing symptoms or if it may become malignant.

Do dermoid cysts go away without treatment?

No. Some types of ovarian cysts eventually disappear on their own, but dermoid cysts stay unless they’re removed.

How is it treated?

Treating ovarian dermoid cysts requires removing the cyst and, in rare cases, the affected ovary. The options available depend on how concerning the cyst is and your plans to have children.

• Ovarian cystectomy: Removes the part of the ovary with the cyst. This procedure eliminates the cyst while preserving your fertility.
• Oophorectomy: Removes the entire ovary with the cyst.

Most providers remove ovarian dermoid cysts using laparoscopy, or “keyhole surgery.” This type of surgery involves small, strategic cuts into your abdomen. Your provider may recommend a different surgery called laparotomy if your cyst is especially large, if you have cysts on both ovaries or if the cyst may be malignant. A laparotomy involves a more significant cut into your abdomen.

Your provider can advise you on the best surgical options available, depending on your unique case.

How can I reduce my risk of an ovarian dermoid cyst?

You can’t reduce your risk. Ovarian dermoid cysts form before you’re born.

What can I expect if I have an ovarian dermoid cyst?

Your provider may recommend surgery to remove your cyst if they're concerned that it could rupture or twist your ovary. If it doesn’t cause immediate concern, they may monitor it instead.

Do dermoid cysts grow back after removal?

Surgery is an effective cure for your cysts. Ovarian dermoid cysts grow back after removal in only 3% to 4% of cases.

When should I see my healthcare provider?

In addition to seeing your provider for regular ultrasounds to monitor your cyst, pay attention to signs of a ruptured cyst or ovarian torsion. See your provider right away if you notice these symptoms:

• Excruciating pain in your abdomen (often but not always on the lower right side).
• Nausea and/or vomiting.
• Dizziness.
• Bleeding.
• Fever.

Is an ovarian dermoid cyst a baby?

No. An ovarian dermoid cyst is a collection of mature tissue and sticky fluid that forms when cells grow atypically.

A note from Cleveland Clinic

Learning that you have a cyst inside of your body that contains tissue like skin and hair can feel scary, strange and even icky. The good news is that these growths are benign. Receiving a diagnosis means that your provider knows about and can monitor your cyst. They can remove it if there’s a chance of complications that could cause you harm. Talk to your healthcare provider about any concerns.