Cysts and Dermoid Cysts
Generally, a cyst is a closed sac with an intact covering that is distinct (or separated) from the nearby tissues. These sacs may vary in size and may contain a variety of body fluids or tissues. The number of different kinds of cysts that can occur in children is quite large. In general, most of these cysts are benign (doesn’t threaten health or life) and slow growing. The most common type of cyst seen in pediatric patients is dermoid cysts.
A dermoid cyst is a mature cystic teratoma (slow growing tumor) that contains structures characteristic of normal skin. In pediatric patients, dermoid cysts are small discreet masses that occur most commonly in the head and neck, especially near the lateral eyebrow ( side of the eyebrow).
The only reliable treatment for dermoid cysts is surgery to remove it. Dermoid cysts often contain both a cyst wall and a central mass of cheese-like material. This material is often viscous or thick and is not well treated by aspiration (insertion of a needle). In order to fully remove the cyst, surgical excision and removal of all components of the cyst is generally required.
In-depth look into Dermoid Cysts
Dermoid cysts generally occur at a characteristic location next to the lateral eyebrow. However, they can occur anywhere throughout the body due to an error in development. They are very common in the head and neck area of pediatric patients and plastic surgeons are commonly asked to treat them due to their presence in visible areas of the body. Occasionally, these cysts occur in unusual locations such as partially within the brain or eye socket. When this is the case, removal of the cyst may require involvement of a neurosurgeon or ophthalmologist.
Dermoid cysts generally presents as a painless swelling or mass. They grow slowly and can be treated before they cause damage to surrounding structures. If left untreated, they can cause distortion of surrounding bones, rupture, or become infected. The standard treatment is surgical excision of the cyst before any of these things occur.
Signs & Tests
Signs that your child might have a dermoid cyst include a swelling or mass near the lateral (sides of the) eyebrow, or in any location on the skull. Sometimes these masses grow proportionately with your child and sometimes the growth is faster.
Most dermoid cysts can be diagnosed by your plastic surgeon following a full physical exam. Often, no further testing is required. However, there are dermoid cysts that occur in unusual locations (midline lesions near the nose, or on parts of the skull other than the lateral brow). Generally, dermoid cysts in unusual locations require a CT scan to make sure the lesion does not communicate with the brain or other surrounding structures.
Treatment & Care
Treatment of dermoid cysts generally requires surgery. This involves making an incision in the skin and dissecting the cyst away from any surrounding structures. For cysts in the lateral brow this can be accomplished from an incision over the brow or the upper eyelid. This surgery generally removes the entire cyst and provides a definitive treatment.
Following surgery, your surgeon will want to see your child at a postoperative visit. At this visit the surgeon will check on the healing of the surgical incision and discuss any pathology report with you.