What are the types of dermoid cysts appearing in the ovary?

Updated: Feb 12, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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For gynecologists and general pathologists a dermoid cyst is primarily associated with a cystic tumor of the female ovary.

Cystic teratoma is a relatively rare tumor that most often occurs in females aged 15-40 years. A cystic teratoma consists of a thick leatherlike capsule that covers amorphous fatty masses and poorly to fully differentiated structures derived from the ectoderm. Most ovarian dermoid cysts contain skin and skin adnexa, including prominent sebaceous glands, hairs, and nails, but also teeth or eyes. Melanotic changes may also occur. Rare cases of multiple dermoid cysts of the omentum have been reported. [29] Dermoid cysts of the ovary are usually benign and easy to remove.

Malignant melanomas may originate from melanocytes in ovarian cystic teratomas. Two new cases and 17 older cases in the literature (reported from 1903-1995) are described and were critically reviewed. The present authors found 17 additional cases of benign and malignant melanotic ovarian lesions that were not associated with a dermoid cyst, including 4 melanomas, 3 benign nevi, 5 benign melanosis, and 4 benign and malignant retinal anlage tumors. The extremely rare primary ovarian melanoma was differentiated from the more common melanoma metastatic cyst of the ovary by its unilaterality, the presence of junctional change, and detailed history taking and physical examination, the findings of which excluded other primary sites. [30]

Three patients with metastasizing squamous cell carcinoma from a dermoid cyst of the ovary are described. [31] Malignant transformation in a dermoid cyst is a rare complication and mainly occurs in older individuals. Although the prognosis is poor, aggressive therapy may result in long-term remission.

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