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Dermoid Eye Cyst - Causes, Risk Factors, Diagnosis and Treatment

Published on Apr 28, 2022   -  6 min read

Abstract

The dermoid eye cyst is an epithelium-lined cavity filled with ectodermal components. Read the article below to know more about dermoid eye cysts.

Contents

What Is Dermoid Eye Cyst?

A dermoid cyst of the eye is congenital (since birth) choristoma. Choristomas are tumor-like growth of normal cells in an abnormal location. Dermoid cysts are structures originating from ectoderm like hair follicles, keratin, sweat, and sebaceous glands. More than eighty percent of the dermoid cysts occur in the head and neck region, out of which dermoid cysts of the eye are the most common. The dermoid cysts of the eyes include orbital, conjunctival, and corneal cysts. Most common among them are the orbital dermoid cysts, whereas conjunctival and corneal cysts are uncommon.

What Causes Dermoid Eye Cyst?

Sequestration (inclusion) of epithelium embryologically is the leading cause of dermoid eye cysts. In addition, there is entrapment of epithelial cells during the closure of frontomaxillary, frontotemporal and frontozygomatic sutures.

The three significant dermoid eye cysts differ in their epithelium lining and internal structure. The different types of dermoid cysts are:

  1. Orbital Cyst: In orbital cysts, sequestration of the squamous epithelium occurs. It is a cystic lesion.

  2. Conjunctival Cyst: It is lined by conjunctival epithelium containing goblet cells. It is a solid tumor.

  3. Corneal Cyst: It is lined by squamous epithelium and has ectodermal and mesodermal structures (from mesoderms like blood vessels, fat cells, and cartilage) components. It is a solid tumor.

What Are the Clinical Features of Dermoid Eye Cyst?

All three cysts show changes in their site of appearance, time of occurrence, and specific signs and symptoms.

Following are the clinical features of the different types of dermoid eye cyst:

Some of the typical clinical signs which may appear in patients suffering from all the three types of dermoid cysts of the eye include:

  1. Palpable mass.

  2. Ptosis (drooping of the upper eyelid).

  3. Proptosis (bulging eyes).

  4. Strabismus (cross eyes).

  5. Pulsating proptosis with mastication.

  6. Globe displacement.

  7. Restriction in extraocular movements.

  8. inflammation.

  9. Orbitocutaneous fistula.

What Are the Different Clinical Forms of Dermoid Eye Cysts?

The orbital and corneal dermoid cysts occur in various forms clinically.

1. Orbital Dermoid Cyst:

Based on the depth of invasion:

Based on the size of the tumor:

Based on the location of the suture to the surrounding bone and soft tissue:

Based on the type of growth:

2. Corneal Cysts:

Based on their severity of clinical presentation:

What Are the Risks and Syndromes Associated With a Dermoid Eye Cyst?

The dermoid cysts of the eye pose several risks to the patient depending upon their size and extent.

How Can We Diagnose Dermoid Eye Cyst?

It can be easily detected by clinical examination. However, radiographic diagnostic procedures also play a vital role in the cyst's confirmatory diagnosis. These include:

What Is the Need for Treating Dermoid Cyst Tumors of the Eye?

The removal of dermoid cysts of the eye may minimize the cosmetic compromise and risk of amblyopia and recurrent inflammation linked with the cysts.

Can Dermoid Eye Cysts Be Treated?

For all cysts, the treatment of choice is surgical excision. However, the mode of treatment for a particular cyst depends upon the cyst size that might include the following:

Are There Any Other Tumors Which Mimic Dermoid Eye Cyst?

Does Dermoid Eye Cyst Have Good Prognosis?

Orbital dermoid cysts have a good prognosis. Surgical excision does not cause further complications and exhibits very few recurrence rates.

What Are the Drawbacks of Surgery Excision of Dermoid Eye Cyst?

Surgical excision of the dermoid eye cyst can cause a few post-surgical complications. Some of these complications include -

Conclusion:

Dermoid eye cysts are benign eye tumors. They originate from the ectodermal germ layer due to the inclusion of epithelium during fetal development. They are diagnosed both clinically and radiographically. Clinically, they appear as smooth, painless masses. Dermoid cysts are cured surgically with a minimal recurrence rate. It is essential to seek the advice of a healthcare provider if you experience any of the symptoms of a dermoid eye cyst.

Frequently Asked Questions


1.

How to Remove Orbital Cysts?

The best choice of treatment for the removal of orbital cysts is surgical removal that is preceded by diagnosis. In the case of large cysts, first, the contents of the lesion are drained, followed by surgical removal.

2.

Can Dermoid Cysts Be Dangerous?

Dermoid cysts are not a serious condition. They are slow-growing, painless, firm masses seen in several regions of the body. Dermoid cysts are harmless lesions. They are tumor-like growth of normal skin cells in abnormal locations.

3.

Are Dermoid Cysts Cancerous?

Dermoid cysts are harmless and benign conditions and tend to grow slowly. They are a type of choristoma. Choristomas are tumor-like growth of normal cells in abnormal locations.

4.

Is Dermoid Cyst Seen in Adults?

Dermoid cysts are present at birth, but sometimes they appear clinically in adults. The age group in which there the dermoid cysts occur normally is between 15 years to 40 years. Orbital and conjunctival dermoid cysts occur in children immediately after birth.

5.

How Does a Dermoid Cyst Appear Clinically?

Dermoid cysts clinically appear as yellow or white solid masses in the orbit, conjunctiva, or the corneal region of the eye, as well as in several other regions of the body. They are slow-growing, painless masses that can sometimes be large enough to displace the normal anatomy.

6.

How to Remove a Dermoid Cyst?

Small lesions without any symptoms do not require any treatment as they may regress spontaneously. However, large lesions are managed by surgical excision.

In the case of a very large cyst, first, the contents are drained, followed by excision and surgical removal.

7.

Can Dermoid Cysts Be Congenital?

Dermoid cysts are a type of congenital cysts. Congenital cysts are lumps or masses present in the head and neck region from birth. Dermoid cysts may not always present clinically at birth. Sometimes they appear clinically only in adulthood.

8.

Is Dermoid Cyst a Cause of Baldness?

Ovarian dermoid cysts in females are linked to the irregular menstrual cycle. The abnormality in the periods presents clinically as acne, growth of hair all over the body, and thinning of scalp hair.

9.

Can Dermoid Cysts Recur?

Dermoid cysts are usually present at birth and usually get completely resolved after surgical removal of the cyst. They have a tendency to recur in case of incomplete removal of the cystic contents. Ovarian dermoid cysts have a higher recurrence rate in children and adolescents.

10.

How Are Dermoid Cysts Diagnosed?

Most dermoid cysts can be detected clinically. Apart from the clinical diagnosis, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound are also helpful. A biopsy is a gold standard for diagnosing a cyst.

11.

Are Dermoid Cysts Familial?

The pathogenesis of the dermoid cyst also has a genetic basis. In most cases, at least one first-degree relative of the family is also predisposed to contracting the condition.

12.

How Much Time Does It Take To Recover After Surgery of Dermoid Cyst?

Surgical removal of the dermoid cyst is safe. The time taken by the patient to recover depends upon the type of suturing, if the cyst area after removal is left open, it takes several months to heal, whereas closed stitches heal within four weeks.

13.

How Long Does It Take for a Dermoid Cyst to Grow?

Dermoid cysts are slow-growing cysts. They are sac-like growth of skin and its structures. They may present early in life, usually at birth, but grow slowly to a substantial size in adulthood.

14.

Can Dermoid Cyst Hurt?

When dermoid cysts are very large, they usually displace the anatomical structure out of its place, this results in the compression of any nearby nerve, which leads to the onset of pain. Rupturing of the cyst is also related to the spreading of infection, leading to pain.

15.

Are Dermoid Cysts and Teratoma Same?

An ovarian dermoid cyst is a mature type of teratoma. Teratomas are germ cell tumors that contain mature or immature skin and bony structures such as teeth, hair, bone, etc. It affects people of wide age groups.

16.

What Happens When a Dermoid Cyst Bursts?

Rupture of the dermoid cyst, such as the ovarian and abdominal dermoid cyst, is often accompanied by a sudden, intense sharp pain in the abdomen. In the case of the ovarian dermoid cyst, it can be lethal. It can also cause infection in the surrounding regions.

17.

Can Dermoid Cyst Affect Fertility?

A dermoid cyst of the ovaries can be best treated with surgical removal. Patients with ovarian dermoid cysts overall have a good chance of getting pregnant. The dermoid cyst does not affect fertility.

18.

What Hormones Are Secreted by Dermoid Cysts?

Ovarian dermoid cysts, in rare cases, have a tendency to secrete hormones like the adrenocorticotropic and human chorionic gonadotropin hormones. The secretion is due to the presence of pituitary cells inside the cyst.

19.

Is a Dermoid Cyst Heterogenous in Nature?

Dermoid cysts are heterogenous cysts. They have both soft tissue and hard tissue components such as skin, sebaceous glands, hair, teeth, and bone structures present in them. In imaging, it usually appears like a teratoma.

20.

What Happens After Dermoid Cyst Removal?

Dermoid cysts of the head and neck region, if not removed, lead to cosmetic compromise. A dermoid cyst, if left untreated, can grow large enough to displace the normal structure from its place and can also cause infection to the surrounding structures.

21.

How Are Orbital Dermoid Cysts Formed?

Orbital dermoid cysts are sac-like cavities that are formed due to the entrapment of the epithelium lining the different parts of the eyes, including the cornea, conjunctiva, and the orbit, during the closure of the suture.

22.

Do Dermoid Cysts Disappear by Themselves?

Dermoid cysts, which are very small, may resolve by themselves. Large cysts require surgical intervention for their removal. They do not disappear by themselves. They may recur if the removal of the cyst is not complete.

23.

What Does a Dermoid Cyst Contain?

Dermoid cysts are composed of structures formed from the outermost germ layer, also known as the ectodermal layer. It comprises hair follicles, teeth, bony structure, sweat glands, sebaceous glands, and keratin.

24.

What Is the Ideal Size for Removal of Dermoid Cyst?

Very large dermoid cysts are preferred to be surgically removed. Surgery is recommended for ovarian cysts measuring at least 2.4 inches in diameter. Dermoid cysts above 5 cm in size are eligible for surgical removal.

25.

Is Dermoid Cyst a Common Entity in Newborns?

Dermoid cysts are the most common cysts occurring in newborns. Dermoid cysts of the periorbital and orbital region are the most frequently encountered cysts seen in newborns.

26.

What Is the Minimum Age for Surgical Removal of the Dermoid Cyst?

Very large dermoid cysts are recommended to be surgically removed as early as possible. Surgical removal of the cyst should be performed only when the newborn attains six months of age.

Last reviewed at:
28 Apr 2022  -  6 min read

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