What is a Dermoid Cyst?

I was diagnosed with a dermoid cyst, and I'm having it removed. Can you tell me what it is and how I got it? I'm concerned about my fertility and whether it will be affected. I really want to conceive, but I'm scared.

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A dermoid, or mature teratoma, is a benign type of ovarian tumor. Dermoids are common, constituting about one-third of all benign ovarian tumors. They are often found in young women. Dermoids rarely become cancerous. Cancer occurs in only 1-2 percent of cases, usually in women over 40. There is a similar tumor called an immature teratoma that is cancerous but rare (accounting for 1 percent of all ovarian cancers). In roughly 10 percent of cases of dermoids, these cysts will be found in both ovaries.

Dermoid ovarian cysts are bizarre because they contain many different types of cells. They arise from a single cell that has the potential to become anything in the body. They are often filled with a greasy, thick fluid and may contain hair, cartilage and even well-formed teeth! Sweat glands, thyroid tissue and muscle fibers may also be found. Old textbooks showed dermoids as a tiny "humunculous," or human being within the ovary.

Dermoids often cause no symptoms and are noted as an enlargement of the ovary on a routine pelvic exam. However, they may twist on themselves and cause severe pain, and occasionally they rupture, producing peritonitis, or irritation of the abdominal and pelvic cavity. In order to prevent these complications, it's best to remove dermoids when they are found. The surgery will involve removing the dermoid itself; unless it involves the entire ovary, the rest of the ovary is left behind. The surgeon may use either laparoscopy (surgery using miniature tools through tiny incisions) or an open approach, depending on the size and location of the dermoid as well as the surgeon's skill.

Removal of a dermoid should not affect your fertility. As with any pelvic surgery, care must be taken to prevent the formation of adhesions (scar tissue). I usually place a substance called Interceed over the ovaries after I remove a large cyst. As long as you have some normal ovarian tissue left -- even if part of both ovaries are removed -- you will still ovulate, and you may become pregnant. As a matter of fact, I recently delivered the first child of a young women whose dermoid I removed two years ago!

by Kelly Shanahan

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