Adermoidcystisacysticteratomathatcontainsdevelopmentallymatureskincompletewithhairfolliclesandsweatglands,sometimesluxuriantclumpsoflonghair,andoftenpocketsofsebum,blood,fat,bone,nails,teeth,eyes,cartilage,andthyroidtissue.
英文名,概述,Location,Treatment,Differentialdiagnosis,
英文名
dermoidcyst
概述
Adermoidcystisacysticteratomathatcontainsdevelopmentallymatureskincompletewithhairfolliclesandsweatglands,sometimesluxuriantclumpsoflonghair,andoftenpocketsofsebum,blood,fat,bone,nails,teeth,eyes,cartilage,andthyroidtissue.Becauseitcontainsmaturetissue,adermoidcystisalmostalwaysbenign.Theraremalignantdermoidcystusuallydevelopssquamouscellcarcinomainadults;inbabiesandchildrenitusuallydevelopsendodermalsinustumor.
Someauthorsusethetermdermoidcystasafranksynonymforteratoma,meaninganyteratoma,regardlessofitshistologyorlocation.Othersuseittomeananymature,cysticteratoma.Theseusesappeartobemostcommoningynecologyanddermatology.
Someauthorsusethetermdermoidcystasafranksynonymforteratoma,meaninganyteratoma,regardlessofitshistologyorlocation.Othersuseittomeananymature,cysticteratoma.Theseusesappeartobemostcommoningynecologyanddermatology.
Location
Adermoidcystcanoccurwhereverateratomacanoccur.
Periorbitaldermoidcysts
Dermoidcystscanappearinyoungchildren,oftennearthelateralaspectoftheeyebrow(rightpartoftherighteyebroworleftpartofthelefteyebrow).Itoftenhasarubberyfeel.Thesearesometimeswatchedandsometimesexcised.Aninflammatoryreactioncanoccurifthedermoidcystisdisrupted.
Dermoidcystscanrecurifnotcompletelyexcised.Sometimes,completeexcisionisnotpracticalifinadumbbellconfigurationwherethecystextendsthroughasuturelineintheskull.
Ifthedermoidcystsappearonthemedialaspect,thepossibilityofanencephalocelebecomesgreaterandshouldbeconsideredamongthedifferentialdiagnosis.
Periorbitaldermoidcysts
Dermoidcystscanappearinyoungchildren,oftennearthelateralaspectoftheeyebrow(rightpartoftherighteyebroworleftpartofthelefteyebrow).Itoftenhasarubberyfeel.Thesearesometimeswatchedandsometimesexcised.Aninflammatoryreactioncanoccurifthedermoidcystisdisrupted.
Dermoidcystscanrecurifnotcompletelyexcised.Sometimes,completeexcisionisnotpracticalifinadumbbellconfigurationwherethecystextendsthroughasuturelineintheskull.
Ifthedermoidcystsappearonthemedialaspect,thepossibilityofanencephalocelebecomesgreaterandshouldbeconsideredamongthedifferentialdiagnosis.
Treatment
Treatmentfordermoidcystiscompletesurgicalremoval,preferablyinonepieceandwithoutanyspillageofcystcontents.Marsupialization,asurgicaltechniqueoftenusedtotreatpilonidalcyst,isinappropriatefordermoidcystduetotheriskofmalignancy.
Theassociationofdermoidcystswithpregnancyhasbeenincreasinglyreported.Theyusuallypresentthedilemmaofweighingtherisksofsurgeryandanesthesiaversustherisksofuntreatedadnexalmass.Mostreferencesstatethatitismorefeasibletotreatbilateraldermoidcystsoftheovariesdiscoveredduringpregnancyiftheygrowbeyond6cmindiameter.Thisisusuallyperformedthroughlaparotomyorverycarefullythroughlaparoscopyandshouldpreferablybedoneinthesecondtrimester.
Theassociationofdermoidcystswithpregnancyhasbeenincreasinglyreported.Theyusuallypresentthedilemmaofweighingtherisksofsurgeryandanesthesiaversustherisksofuntreatedadnexalmass.Mostreferencesstatethatitismorefeasibletotreatbilateraldermoidcystsoftheovariesdiscoveredduringpregnancyiftheygrowbeyond6cmindiameter.Thisisusuallyperformedthroughlaparotomyorverycarefullythroughlaparoscopyandshouldpreferablybedoneinthesecondtrimester.
Differentialdiagnosis
Asmalldermoidcystonthehead(skullsutures,andmidline:sinus,nose,palate,tongue,underthetongue,etc.)orthecoccyxcanbedifficulttodistinguishfromapilonidalcyst.Thisispartlybecausebothcanbefullofhair.Apilonidalcystisapilonidalsinusthatisobstructed.Anyteratomanearthebodysurfacemaydevelopasinusorafistula,orevenaclusterofthese.SuchisthecaseofCanadianFootballLeaguelinebackerTyroneJones,whoseteratomawasdiscoveredwhenheblewatoothoutofhisnose.
Treatment
Treatmentfordermoidcystiscompletesurgicalremoval,preferablyinonepieceandwithoutanyspillageofcystcontents.Marsupialization,asurgicaltechniqueoftenusedtotreatpilonidalcyst,isinappropriatefordermoidcystduetotheriskofmalignancy.
Theassociationofdermoidcystswithpregnancyhasbeenincreasinglyreported.Theyusuallypresentthedilemmaofweighingtherisksofsurgeryandanesthesiaversustherisksofuntreatedadnexalmass.Mostreferencesstatethatitismorefeasibletotreatbilateraldermoidcystsoftheovariesdiscoveredduringpregnancyiftheygrowbeyond6cmindiameter.Thisisusuallyperformedthroughlaparotomyorverycarefullythroughlaparoscopyandshouldpreferablybedoneinthesecondtrimester.
Theassociationofdermoidcystswithpregnancyhasbeenincreasinglyreported.Theyusuallypresentthedilemmaofweighingtherisksofsurgeryandanesthesiaversustherisksofuntreatedadnexalmass.Mostreferencesstatethatitismorefeasibletotreatbilateraldermoidcystsoftheovariesdiscoveredduringpregnancyiftheygrowbeyond6cmindiameter.Thisisusuallyperformedthroughlaparotomyorverycarefullythroughlaparoscopyandshouldpreferablybedoneinthesecondtrimester.
Differentialdiagnosis
Asmalldermoidcystonthehead(skullsutures,andmidline:sinus,nose,palate,tongue,underthetongue,etc.)orthecoccyxcanbedifficulttodistinguishfromapilonidalcyst.Thisispartlybecausebothcanbefullofhair.Apilonidalcystisapilonidalsinusthatisobstructed.Anyteratomanearthebodysurfacemaydevelopasinusorafistula,orevenaclusterofthese.SuchisthecaseofCanadianFootballLeaguelinebackerTyroneJones,whoseteratomawasdiscoveredwhenheblewatoothoutofhisnose.
