Understanding Ovarian Dermoid Cysts and When to Seek Care

Ovarian dermoid cysts are one of the most unique and common types of benign ovarian growths. They can appear at any age, but they are most often diagnosed in women during their reproductive years. At Complete Healthcare in Richland WA, we frequently evaluate and treat ovarian cysts, and many patients feel reassured once they understand what dermoid cysts are, how they form, and when removal may be recommended. Although the word cyst can be alarming, dermoid cysts are usually noncancerous and can be managed safely with the guidance of a trained OB GYN.

A dermoid cyst, also known as a mature cystic teratoma, forms from germ cells. These cells are capable of developing into different tissue types. Because of this, dermoid cysts can contain a variety of structures including hair, skin, fat, or occasionally teeth or cartilage. This may sound surprising, but the presence of these tissues is simply a result of how germ cells develop. The cyst itself grows slowly and often remains unnoticed for many years.

Most dermoid cysts are found during pelvic ultrasound. In many cases, they are discovered accidentally during imaging for another concern or routine evaluation. A dermoid cyst typically appears as a complex mass with areas of fat or calcifications, which helps differentiate it from other types of ovarian masses. Once identified, the size and appearance of the cyst guide the next steps in management.

Symptoms from a dermoid cyst are variable. Many women have no symptoms at all. When symptoms do occur, they may include pelvic pressure, bloating, or discomfort on one side. The most significant risk associated with dermoid cysts is ovarian torsion, which occurs when the ovary twists around its supporting structures. This can cut off blood supply to the ovary and cause severe pain that requires urgent medical attention. Larger dermoid cysts increase this risk because they add weight to the ovary, making it more likely to rotate.

Management of a dermoid cyst depends on several factors. These include the size of the cyst, whether symptoms are present, the patient's age, and the risk of complications. Small dermoid cysts that do not cause symptoms may simply be monitored with periodic imaging. However, cysts that reach a certain size or continue to grow are more likely to require surgical removal. Cysts larger than five to six centimeters carry a higher risk of torsion and are often surgically treated to prevent emergency situations.

Surgical management typically involves minimally invasive laparoscopy. This technique uses small incisions, allowing the surgeon to carefully remove the cyst while preserving as much normal ovarian tissue as possible. Recovery is usually quicker and less painful compared with traditional open surgery. The goal is always to maintain ovarian function whenever possible, especially for women who desire future fertility. In rare situations where the cyst completely replaces normal ovarian tissue or cannot be safely separated, removal of the affected ovary may be necessary, but this is not common.

Pathology evaluation after surgery confirms the diagnosis. Dermoid cysts are almost always benign. Malignant transformation is extremely rare and occurs primarily in older women. The likelihood of cancer in a dermoid cyst is very low in reproductive age patients. This is one reason why a thorough ultrasound and clinical evaluation are essential. When a dermoid cyst has classic imaging features, the need for additional testing is usually limited.

For women planning pregnancy, dermoid cysts can create unique considerations. Most dermoid cysts do not interfere with fertility. However, if a cyst is large or poses a risk for torsion, removal before pregnancy is often recommended. Once pregnant, torsion risk may increase because the ovaries shift position as the uterus enlarges. Planning ahead with a careful treatment strategy helps reduce the chance of emergency surgery during pregnancy.

At Complete Healthcare, we take a personalized and thorough approach when evaluating ovarian cysts. Our team reviews ultrasound findings in detail, explains expected behavior of dermoid cysts, and discusses the benefits and risks of observation versus removal. We also consider each woman's reproductive goals, age, and symptoms when developing a treatment plan. Patients are encouraged to ask questions and participate actively in decision making. Understanding the nature of a dermoid cyst helps ease anxiety and empowers patients to make informed choices about their care.

If you have recently been told you have a dermoid cyst or are experiencing pelvic pain or pressure, an evaluation can provide clarity and reassurance. With expert ultrasound assessment and individualized treatment planning, most dermoid cysts can be managed safely and effectively. Our goal at Complete Healthcare is to provide compassionate, evidence based care for all gynecologic conditions, allowing our patients to feel confident and supported throughout the process.

Complete Healthcare - Obstetrics and Gynecology

509-392-6700

Richard Lorenzo, D.O.

Kortney Jones ARNP