Dermoid Cyst

What is a dermoid cyst?

A dermoid cyst is a sac or growth in or on the body that that contains fluid or semisolid material. A dermoid cyst is considered a congenital defect or abnormality, meaning the problem occurred during fetal development.

A dermoid cyst is benign, meaning it is not cancerous. The cyst occurs during fetal development when layers of specialized cells do not grow together properly, and cells that should be on the outside of the body become trapped inside the body — for example, cells from skin, sweat glands or hair.

As these skin, hair or sweat glands shed and produce their normal substances, they collect inside the cyst and the cyst grows.

Symptoms

The following are the most common symptoms of a dermoid cyst. However, each child may experience symptoms differently. The symptoms of a dermoid cyst may resemble other neck masses or medical problems. Always consult your child’s physician for evaluation and management.

Dermoid cysts are usually found on the head, neck and face, but can occur anywhere on the body.

The cyst typically appears as a small, often painless, lump frequently located on the neck, scalp, forehead, nose or around the eye. The lump may be skin-colored, or may have a slight yellow tinge.

A pit (tiny opening) may be present on the cyst. The pit could have hair or “cheesy” material expressed from it

Diagnosis

Dermoid cysts are diagnosed by physical examination. Generally, the mass can be easily moved beneath the skin, and is painless.

In addition to a complete medical history and physical examination, diagnostic procedures to determine if the cyst is connected to other tissues in the head and neck may include a CT scan or MRI.

At CHOP, we see a great number of patients with cysts such as the dermoid cyst. We use additional testing as needed to make an accurate assessment, then present you with treatment options based on the test results.

Treatment

Specific treatment of a dermoid cyst will be determined by your child's physician based on:

  • Your child’s age, overall health and medical history
  • Location and extent of the cyst
  • Your child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Dermoid cysts tend to enlarge slowly over time, so treatment often includes surgery to remove the cyst when it is first detected. Aspirating the cyst with a needle, or lancing/draining it is not an option because the cyst lining needs to be removed in order for it to not grow back.

Depending on the location of the cyst, your child may see one of our pediatric general surgeons, an otolaryngologist (ENT) surgeon, a plastic and reconstructive surgeon, or a neurosurgeon, or a combination of these experts to best treat your child's unique condition.

Dermoid cysts that occur in the middle of the face often appear between the eyes or on the nose. Because of the location, cysts in this region are evaluated with an MRI to determine if the cysts extends deeply, has attachments inside the face, or extends into the brain. Any connection with the skull requires a more complex procedure performed with a neurosurgeon. The involved skin, the cyst, and any connection through bone into the brain are removed together through an incision in the skin combined with an intracranial approach.

If it is a simple cyst outside the bones of the skull (no deeper extension inward), the cyst is removed through a simple incision in the skin.

What to expect during your child’s surgery

Surgery to remove a dermoid cyst is typically done as an outpatient procedure. You will bring your child to the hospital or surgery center where you will meet with a surgeon and a surgical nurse practitioner. The surgery, preparation and follow-up will be explained to you in detail and you will have a chance to ask questions.

After all pre-surgical prep is done, your child will go under general anesthesia and the cyst will be removed. Your child will be monitored before, during and after the procedure. Once he or she has recovered from the anesthesia, your child will return home.

Follow-up care

Your child will return for a follow-up visit to check the incision, but typically there is no need for additional monitoring or treatment.

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