A dermoid ovarian cyst is a benign tumor located on the tissues of an organ. It has the appearance of a capsule with dense walls and is held on the appendages by the legs. In a different way, experts call this neoplasm a dermoid or mature teratoma.
Pathology Features
Inside, the neoplasm is lined with epithelium, contains sebaceous and genital glands, as well as bone, nervous and other types of tissues.
Usually, such a cyst damages only one organ. In approximately 2-3% of all patients, it is converted to squamous cell carcinoma.
According to statistics, a dermoid cyst in the left ovary occurs much less often than in the right. Most likely, this is due to the fact that the organs are asymmetrically in relation to each other. The right appendage prevails over the left, in other words, performs more functions and is ahead of it in size.
A dermoid cyst of the right ovary is treated in the same way as a tumor in the left organ. The tumor can be found in women of any age. As a rule, it has a size of approximately 3-5 cm and only occasionally grows to 15 cm.
Appearance
A dermoid cyst is a benign tumor. About 18-20% of women with ovarian neoplasms face it. Such a cyst usually has an oval or round shape, smooth outer walls and an impressive diameter.
The internal cavity of the dermoid consists of epithelium and jelly-like contents with large fragments of derivatives of the endoderm, ectoderm and mesoderm - hair, bones, sweat and sebaceous glands, fat and nerve tissues.
Clinical picture
Often, a cyst is formed on the basis of embryonic leaves of the embryo remaining after an inferior intrauterine tissue separation.
After connecting the egg and sperm, a zygote arises, which is a unicellular organism with the properties of both germ cells. When this formation is crushed, germ layers appear, which gradually shift relative to each other.
At first, the layers have homogeneity, but, interacting with each other, they have a stimulating effect on nearby cells. So, over time, peculiar tissues, organs and structures are created from embryonic leaves.
On the basis of ectoderm, tooth enamel, lens, epithelium, some components of the auditory apparatus and cells of nerve tissues are formed. From the endoderm layer, the membrane of the digestive system develops, the components of the liver, thyroid gland, pituitary gland and intestines. On the basis of the mesoderm lobe, skin, components of the urogenital organs, pulmonary pleura and pericardium are formed.
Causes of dermoid ovarian cysts
The treatment of this pathology, as a rule, does not depend on the factors preceding the disease. However, during therapy it is very important to consider the clinical picture of concomitant diseases, if any.
The causes of the appearance are not exactly known, but, according to doctors, neoplasms in the appendages can develop due to hormonal changes that occur in adolescence and during menopause. The possibility of tumors as a result of trauma to the abdomen is also possible.
In some cases, a dermoid ovarian cyst appears due to the use of certain medications, toxic suffocation, poisoning, prolonged exposure to too high or low temperature, radiation, and also bacterial and viral diseases. All these phenomena are especially dangerous for pregnant women.
Doctors do not deny the existence of other conditions that provoke the appearance of a dermoid, which are still unknown.
Symptoms of pathology
According to numerous reviews, the dermoid ovarian cyst develops rather slowly, so it rarely makes itself felt and is usually found during a routine examination. Pathogenesis becomes apparent when the neoplasm begins to grow actively, pushing apart the tissues of the organ, due to which the blood flow of the appendage worsens significantly.
Drawing pain in the lower abdomen without a clear localization, moving to other places, appears when the cyst reaches its dimensions, giving it the opportunity to act on organ tissue. In addition to this, often at this stage there are other symptoms of the pathology:
- discomfort and a feeling of heaviness in the abdominal region;
- upset stool in the form of constipation or diarrhea, as well as their alternation;
- frequent urge to empty the bladder, occasionally accompanied by burning and soreness;
- an increase in the abdomen, noticeable visually.
It is noteworthy that the presence of a dermoid ovarian cyst in the body does not affect menstruation and does not cause hormonal disruptions.
With the advanced state and the progression of the inflammatory process, the neoplasm provokes the onset of fever and fever up to 39 degrees, as well as severe weakness and abdominal pain. In the case of torsion of the cyst legs, a clinical picture characteristic of pelvioperitonitis may appear. In such a situation, the patient may experience severe pain in the peritoneal region, extending to the leg or rectum, as well as fever.
Diagnosis of the disease
As a rule, a dermoid cyst is detected at the time of a simple examination on a gynecological chair. But in order to accurately confirm the suspected diagnosis, the doctor can refer the patient for additional examinations:
- Ultrasonography. The process uses a transvaginal sensor that is inserted into the vagina. The examination allows you to identify the dermoid, as well as accurately determine its location and dimensions.
- MRI As a rule, it is used when other methods have not allowed to establish a type of neoplasm.
- Bimanual research. In the process, the specialist palpates a plastic and mobile circular neoplasm, which does not cause the patient discomfort.
- X-ray of the abdominal cavity. A mature tumor will be clearly visible in the picture, since it contains at this stage the remains of teeth, bones, etc.
- Pregnancy test. It is necessary to exclude the likelihood of developing an ectopic fetus.
- A kind of laparoscopy. Due to it, you can examine the cyst, receiving its image on a special screen using a micro camera placed in the abdominal cavity.
- Test for tumor markers. Helps refute or confirm the presence of a cancerous tumor.
Treatment methods
Unfortunately, as a rule, patients with such a diagnosis cannot do without surgical intervention. The use of all kinds of folk recipes and other well-known methods of treating dermoid ovarian cysts in a similar situation will not bring any result. The tumor itself cannot dissolve, since inside it contains many solids in the form of fragments of bones and teeth, and not liquid.
Having identified a neoplasm of this type, you should immediately remove it. Otherwise, the occurrence of all sorts of complications associated with tumor growth is not ruled out. It is extremely rare, but still sometimes such a cyst is converted into a malignant growth.
Operation Options
There are two ways to remove a dermoid ovarian cyst:
- Laparoscopy. The procedure involves performing three punctures in the anterior wall of the abdominal cavity, through which, in fact, all the necessary devices and the camera are inserted into the abdomen. Laparoscopy of a dermoid ovarian cyst takes no more than an hour. But hospitalization may take several days. This technique is used to remove dermoid ovarian cysts, the size of which does not exceed 5 centimeters.
- Laparotomy To carry out this procedure, an incision is made on the wall of the abdominal cavity, which makes it possible to work with internal organs.
Varieties of techniques
There are several types of surgical intervention, depending on the volume of manipulations performed:
- Ovariectomy This procedure involves the removal of a cyst along with the ovary and is used in case of torsion, as well as the death or rupture of the neoplasm.
- Cystectomy During this operation, the dermoid ovarian cyst is completely eliminated, and the nearby tissues remain unchanged. The implementation of such a procedure is possible only if the tumor has small dimensions and has not yet managed to penetrate into the tissues of the organ. The remaining scars will become completely invisible six months after the manipulations. At the same time, the reproductive function remains full.
- Adnexectomy During the operation, not only the cyst itself, but also the fallopian tube, as well as the damaged ovary, are removed.
- Wedge resection. It is often used for tumors with a diameter of not more than 7 centimeters or for torsion of the cyst legs. During the procedure, an abnormal formation and injured tissue are excised. Gradually, the ovary is completely restored.
The type of operation is selected taking into account the age of the patient and the stage of pathology. For example, young girls are most often prescribed a cystectomy, and women who are in the period of menopause - an adnexectomy or ovariectomy. If possible, specialists use laparoscopy to penetrate the abdominal cavity, since it refers to less traumatic surgical interventions.
Dermoid ovarian cyst and pregnancy
A mature abnormal formation with parameters within 3-5 cm does not in any way affect the bearing and development of the fetus. However, the tumor should be constantly monitored by the attending physician, since it can increase in size, because of which it can move, twist and even cause inflammatory processes.
A small cyst, which does not adversely affect nearby organs and does not provoke complications, must be removed six months after birth or directly during them if a cesarean section is used. A tumor that grows in size is removed by surgery, usually at the 16th week of pregnancy.
If you refuse the competent treatment of a dermoid cyst, then the physical activity of the patient can cause torsion of her legs and, accordingly, the development of the inflammatory process. Only in isolated situations does the neoplasm transform from benign to malignant.
The recovery period and its features
After surgery, the patient is often prescribed drug therapy. Commonly used drugs are:
- vitamins E and C to stabilize the functioning of the ovaries;
- antibiotics to prevent the occurrence of postoperative complications;
- hormonal agents to normalize the background;
- immunomodulators in case of serious malfunctions;
- anti-inflammatory drugs that eliminate swelling in the damaged area and reduce the activity of the inflammatory process.
Further forecast
Timely elimination of mature cysts in young girls, as a rule, does not have negative consequences and in no way affects reproductive function. Extremely rare re-occurrence of the tumor. Such a pathology can occur if, at the time of surgery, the ovary was invisible to the eye, embryos of dermoid cysts. After surgery, a woman needs to visit a specialist every six months and undergo an ultrasound examination.
In some cases, after removal of the cyst, some complications appear:
- relapse of an abnormal phenomenon;
- endometriosis;
- hormonal disorders.