Large Dermoid Cyst Research Articles

The Possibility of Laparoscopic Cystectomy for Large Ovarian Dermoid Cyst in Young Age

Study Object: To evaluate the possibility of laparoscopic cystectomy for large ovarian dermoid cyst in young age. Laparotomy usually has been performed for it due to small abdomen and spillage. Materials and Methods: The patients below 15 years-old were 33 of 71 patients. Large cyst (above 6 cm) were 15 of 33 patients. Intervention: The cysts classified to type A and type B according to contents. Type A has more fluid content than thick non-fluid content, and type B is opposite. In type A, cystectomy was modified to minimize the spillage of content by aspiration and suture before dissection of cyst and by immediate suction with suture for rupture. In below 15 years-old, Type A was 27 of 33 patients (81.8%) compared to 5 of 38 (13.2%) in older age (p<0.01). Results: In type A cysts during the operation, no rupture was 28 of 32 patients (87.5%) and ruptures but no spillage to abdomen were 4 (12.5%) and spillage case was none. However, in type B (p<0.05), no rupture was 23 of 39 (58.2%) and rupture but no spillage was 13 of 34.2 (34.2%) and the spillage was 3 of 39 (7.6%). In patients below 15 years-old, all 15 patients with cysts above 6 cm were type A compared to 12 of 18 (66.7%) with the smaller cysts (p<0.01). The spillage rates in below 16 years-old were no rupture 1 of 33 (3.0%), ruptures but no spillage 3 of 33 (88%) compared to in 38 older age patients (12.6%, 34.4% and 53%; p<0.05). Conclusions: Large dermoid cysts in young age has more fluid contents and modified operation to minimize spillage can be possible. Therefore, even in large dermoid cyst of young age, laparoscopic cystectomy is possible and sometimes easier than old age.

Effect of within-endobag method during laparoscopic ovarian cystectomy of dermoid cyst: A retrospective study.

This study aimed to evaluate the effect of within-endobag cystectomy during and after laparoscopic ovarian cystectomy in patients with dermoid cysts. We retrospectively analyzed 84 patients with ovarian dermoid cysts who underwent laparoscopic ovarian cystectomy. In 30 patients, the affected ovary was placed in an endobag before cystectomy and cystectomy was performed within an endobag (within-endobag group), while the remaining 54 patients underwent standard cystectomy without this step (without-endobag group). After cystectomy, the cyst wall was placed in an endobag and was removed from the abdomen. Compared with the without-endobag group, the within-endobag group had a significantly lower rate of cyst content spillage (23.3% vs 72.2%, P < .001) and significantly shorter operation times when the cysts ruptured (23.4 ± 8.6 minutes vs 51.2 ± 28.6 minutes, P < .001). Whereas there was no significant difference in operation time in the absence of cyst rupture between 2 groups (21.2 ± 8.8 minutes vs 31.1 ± 17.4 minutes, P = .111). In patients with cyst rupture, according to the cyst size increase, the operation time was significantly prolonged without-endobag, whereas no significant prolongation was observed in within-endobag cystectomy. Except for operation time, there were no significant differences in cyst length, pain on the first day after surgery, hemoglobin loss, hospital stay, and inflammatory markers (C-reactive protein and white blood cell counts) in both ruptured and unruptured cases between the 2 groups. There were no postoperative complications in the within-endobag group, but 2 cases of perioperative complications occurred in the without-endobag group. No chemical peritonitis due to spillage of the cyst contents was observed in either group. Laparoscopic ovarian cystectomy performed within-endobag can reduce both the spillage rate of cyst contents and operation time regardless of cyst size in patients with ruptured cysts. Therefore, this technique is a good surgical option for the laparoscopic ovarian cystectomy of large dermoid ovarian cysts.

Intraoral route for excising a large dermoid cyst of the floor of mouth: A discussion

Surgical excision is an effective treatment for a dermoid cyst (DC) of the floor of the mouth (FOM). A dichotomy of opinions exist regarding the appropriate approach to surgical excision. In this study, we discuss our experience with excising a large DC via an intraoral route. An 18-year-old female presented with swelling of the submental region for one year. Under general anesthesia, an incision was conducted in the mucosa of FOM. By removing some contents, the cyst was delivered in toto. While some studies have stressed that the location of origin and size of the DC influence the route of excision, other authors have pointed out that by the time both median genioglossal and geniohyoid cysts become large enough to produce symptoms, both the muscles are splayed out and thus, the cysts are more amenable to excision by intraoral approach. This case highlights a dichotomy of opinion regarding the existing literature and to educate the clinicians about the benefits of the intraoral route of excision.

119 Combined laparoscopic-mini laparotomy approach for excision of a large dermoid cyst

Introduction and aims of the study: Big ovarian masses present difficulties when a minimal invasive approach is advocated. The aim of the study is to present a minimal invasive approach that involves a small incision for more accurate and organ preserving surgery. Methods: A minimally invasive approach for excision of a 20cm dermoid cyst is presented. Results and Discussion: Α 20 years old patient presented because of a feeling of pressure in the lower abdomen. Her BMI was 35 Kgr/cm and a mass was palpated in the lower abdomen extending to the umbilicus.

Neck Dermoid Cyst with Rare Imaging Appearance on Ultrasound, Elastography, and Computed Tomography

Dermoid cyst is a type of inclusion cyst and a benign cystic teratoma containing two or more germ cell layers. It can show variable appearance on ultrasound and Computed Tomography (CT) as it is derived from squamous cell epithelium (ectoderm) and contains dermal-derived elements such as skin appendages, hair follicles, sebaceous and sweat glands. It is uncommon for a dermoid cyst to occur in the neck region during old age. The present case report highlights a rare imaging appearance of a dermoid cyst, presenting in a 65-year-old elderly male as a midline neck swelling, displaying a rare “coin in sack” appearance on ultrasound, “sack of marbles sign” on Contrast-Enhanced CT (CECT). On strain elastography, it showed characteristics of a hard mass. Diagnosing this type of large dermoid cyst with its radiological appearance is challenging. Multimodality imaging is often needed for early intervention, to prevent its rupture and transformation into malignancy. The dermoid cyst was surgically excised, and the patient was symptomatically normal on follow-up.

Case of a Large Dermoid Cyst on the Floor of the Mouth Incidentally Diagnosed During Treatment of a Dentofacial Deformity

Case of a Large Dermoid Cyst on the Floor of the Mouth Incidentally Diagnosed During Treatment of a Dentofacial Deformity

An Ovarian Dermoid Cyst in Pregnancy: A Rare Cause of Intrauterine Growth Restriction

The most common ovarian tumour presenting during pregnancy are dermoid cysts, usually present in the second trimester. Mostly dermoid cysts are diagnosed during ultrasound in antenatal period. We report a case of large unilateral dermoid cyst which was missed in all USG done in antenatal period but diagnosed intra-operatively while performing caesarean section for Intra uterine growth restriction (IUGR) with fetal distress. Ovarian cystectomy was done and remaining ovarian tissues were preserved. The large dermoid cyst hampered the proper growth of the fetus in utero leading to IUGR and fetal distress. Ovarian dermoid cyst in antenatal period, a rare cause of IUGR and its successful management prompted us to report this case.

Cervicofacial Necrotizing Fasciitis and Its Relationship with Aeromona Hydrophila

Introduction: Necrotizing fasciitis is a severe polymicrobial infection with rapid progression and significant tissue destruction, which requires immediate antimicrobial and surgical management; the frequent location is in the extremities (pelvic and thoracic), genitals and thorax, its appearance being rare in the cervicofacial region, it is very rarely associated with causal agents such as Aeromonahydrophila, however, the presence of said bacillus in contaminated water can manifest as Fasciitis Cervicofacial necrotizing agent (CNF). Material and Method: A retrospective, descriptive, cross-sectional, observational study was carried out in Maxillofacial Surgery at the “La Raza” Medical Center, for one year. All patients with a diagnosis of Necrotizing Cervicofacial Fasciitis (CNF). For one year who had cultures and blood cultures, with Aeromonahydrophila, who had been cared for in the Maxillofacial Surgery service from October 1, 2013, to October 1, 2014, were included. Discussion: Giant oral floor cysts located under the mylohyoid muscle are usually removed extra orally. We report the case of a large dermoid cyst of the floor of the mouth, with extension at the base of the tongue, removed intraorally. Results: A sample of 7 patients with a diagnosis of Necrotizing Cervicofacial Fasciitis was obtained; dental origin, of which 3 were women and 4 men; the mean age was 66.7 years; A correlation was made with respect to comorbidities, the management was given by the Maxillofacial Surgery service of the “La Raza” Medical Center was surgical and clinical, with support from the central laboratory of the “Dr. Antonio Fraga Mouret ”and the central epidemiology laboratory of the same hospital, blood cultures and bacterial tissue culture (biopsy) were performed, respectively. The taking of cultures was proportional to the number of surgical events, only 3 patients of which their blood cultures reported the development, two of them presented Gram (+) and Gram (-) and the third Gram (+) and Facultative aerobes. From the tissue cultures, the biota reported was: Candida Albicans; Candida Krusei, Morganella morganii, Coryneform bacilli, Enterobacter aerogenes, Trichosporonasahii, Pseudomona aeruginosa and only one developed AeromonaHydrophila. Antibiotic was administered based on the antibiogram obtained individually with specificity for each case as reported in the cultures. Discussion and Conclusion: CNF is an entity rarely associated with Aeromonahydrophila, it is common to find another type of microbiota in this entity, however, it should be known that this A.hydrophila bacillus is frequently isolated in contaminated water and the patient can acquire it by performing any daily activity, more if you have any injury or previous immunocompromise. The importance of medical-surgical management will determine the prognosis of the patient, the correct extension of debridement and resection will allow delimiting the CNF and the multidisciplinary management together will reduce complications (septic shock, multiple organ failure, death) if it is carried out in a timely manner.

Giant Dermoid Cyst of Floor of the Mouth with Extention to the Base of Tongue: Case Report and Review of the Literature

Introduction: Oral floor dermoid cysts are a rare entity. A cyst can cause malfunctions in the upper aerodigestive tract and slurred speech. The treatment of choice is essentially surgical. Case report: A 17-year-old male who presented with progressive swelling in the floor of the mouth since birth. Clinical examination revealed a painless, bulky, and symmetrical swelling in the floor of the mouth, pushing the tongue backward. Discussion: Giant oral floor cysts located under the mylohyoid muscle are usually removed extra orally. We report the case of a large dermoid cyst of the floor of the mouth, with extension at the base of the tongue, removed intraorally. Conclusion: The recommended surgical techniques vary according to the size and anatomical situation of the cysts. The intraoral approach is preferred for cysts that do not extend beyond the mylohyoid muscle.

Torsion of a large ovarian dermoid cyst in the second trimester of pregnancy and its management: a case report

Background: The Dermoid cyst is the most common ovarian germ cell tumor in pregnant women. During pregnancy, the risk of complications such as torsion, rupture,and infection increases in dermoid cysts. Treatment includes follow-up or surgical intervention. The present study reports a case of a large ovarian dermoid cyst in pregnancy and its treatment. Case report: An 18-year-old primiparous woman presented with nausea and severe abdominal pain in the lower left quadrant. On a deep abdominal examination, there was a palpable mass in the area. Ultrasound showed left ovarian torsion of a large dermoid cyst 10×11cm in size. The patient underwent a laparotomy and with the left ovary preserved, the cyst was removed. Ultrasound showed fetal health a few days after surgery. Conclusion: gynecologists should be aware of the possibility of acute ovarian torsion in pregnant women and should have a high level of suspicion. Early surgical intervention reduces the risk of complications

Purse-string suture technique using a mini-Pfannenstiel incision to treat large dermoid cysts

This study describes the purse-string suture technique using a mini-Pfannenstiel incision for the surgical treatment of large ovarian dermoid cysts. We investigated intra and postoperative outcomes in 24 patients who underwent removal of large ovarian dermoid cysts through a mini-Pfannenstiel incision using the purse-string suture technique. The surgical procedure was performed by two experienced surgeons. The mean diameter of the cysts was 11.9 cm. The mean operation time was 46 min and the intraoperative rupture rate was 8.3%. No patient developed chemical peritonitis. The length of hospitalisation was 36 h. The recurrence rate was 8.3% in the same ovary at 1-year follow-up. In conclusion, ovarian dermoid cysts measuring >8 cm in diameter can be effectively treated through a mini-Pfannenstiel incision using the purse-string suture technique.Impact StatementWhat is already known on this subject? Dermoid cysts are the most common ovarian germ cell tumours occurring in the second and third decades of life, and these tumours are usually treated surgically. There is a lack of consensus among gynaecologists regarding the optimal surgical treatment modalities for ovarian dermoid cysts; however, laparoscopic cystectomy is the gold standard for the surgical treatment of dermoid cysts. Notably, aspiration of dense cystic contents may be difficult during laparoscopic cystectomy.What do the results of this study add? Our technique enables easy removal of dense cystic materials including hair and bone fragments. The short operation time, low recurrence rate and the minimal incisional scar serve as advantages of our novel method.What are the implications of these findings for clinical practice and/or further research? This surgical technique can be successfully used in clinical settings with limited facilities for laparoscopic surgery.

1783 Does Robot-Assisted Laparoscopy Improve Outcomes in Ovarian Dermoid Cystectomy?

Study Objective To evaluate whether using robot assisted laparoscopic technique (RAL) reduces cyst disruption with spillage during benign ovarian teratoma cystectomy compared to straight laparoscopic technique (SLA) and laparotomy (LAP). Design Retrospective cross-sectional analysis. Setting Community teaching hospital. Patients or Participants All patients who underwent unilateral ovarian cystectomy with pathology confirmed dermoid cyst from 1/2013 to 12/2018. 101 patients met inclusion criteria. Interventions Unilateral ovarian cystectomy Measurements and Main Results Intraoperative spillage rates were not significantly different for LAP 19/38 (50%), SLA 28/45 (62%), and RAL 12/18 (67%). See table below for complete results. Conclusion Robot-assisted laparoscopy did not reduce intraoperative spillage of dermoid cyst contents compared to traditional laparoscopy or laparotomy. In patients with large (>6cm) dermoid cysts the use of RAL decreased blood loss, length of postoperative hospital stay, need for inpatient admission and conversion to LAP (compared to SLA), but increased the length of surgery and hospital cost compared to LAP. We conclude that larger dermoid cysts may be treated with RAL instead of LAP. Smaller cysts may have equivalent outcomes with traditional laparoscopic techniques.

Sarcomatous transformation with metastatic deposits in the Omentum in Teratoma of the Ovary: A case report and review of the literature

Symptoms: A 25-year-old woman was presented with abdominal pain, mass, and fever. Physical examination revealed a tender abdominal mass and fever. Investigations: Ultrasound abdomen showed a solid and cystic mass arising from the right adnexa. Magenitic Resonance Imaging (MRI) pelvis showed a large dermoid cyst arising from the right ovary, pelvic lymph nodes enlargement, and omental deposits. Interventions: Total abdominal hysterectomy and bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymph nodes excision. Histopathology: Solid diffuse growth of malignant spindle cells with a high number of abnormal mitotic figures and areas of necrosis.

Large Dermoid Cyst of the Floor of the Mouth - An Emphasis on Differential Diagnosis

espanolEste articulo presenta el caso clinico de un gran quiste dermoide lateral en el suelo de la boca, extirpado quirurgicamente por abordaje intraoral, inicialmente diagnosticado erroneamente por estudios de imagen como una ranula. Otros casos de quistes dermoides diagnosticados preoperatoriamente como una ranula estan presentes en la literatura, pero ninguno compara directamente sus aspectos clinicos, radiologicos y terapeuticos. Este articulo tambien tratara estos aspectos para, posiblemente, ayudarles en su diagnostico y manejo correctos. EnglishThis article presents the case report of a giant lateral dermoid cyst in the floor of mouth surgically excised by intraoral approach, initially misdiagnosed by imaging studies as a ranula. Other cases of dermoid cysts preoperatively diagnosed ranulae are present in literature, but none directly compares their clinical, radiological and therapeutic aspects. This article will also discuss these aspects in order to possibly aid in their correct diagnosis and management.

Sarcomatous Transformation with Metastatic Deposits in the Omentum in Teratoma of the Ovary; a case report and review of the literature

Symptoms; the current is a 25 year old woman was presented with abdominal pain, mass, and fever. Physical examination revealed a tender abdominal mass and fever. Investigations; Ultrasound abdomen showed a solid and cystic mass arising from right adnexa. MRI pelvis showed a large dermoid cyst arising from the right ovary, pelvic lymph nodes enlargement and ommental deposits. Interventions; Total abdominal hysterectomy& bilateral salpingo-oophorectomy, omentectomy, pelvic and para-aortic lymph nodes excision Histopathology; solid diffuse growth of malignant spindle cells with high number of abnormal mitotic figures and areas of necrosis Post-Operative period; the patient was given 2 cycles of chemotherapy and she was discharged to come again for 5-6 courses of chemotherapy. Patient was followed up for one year, no recurrence or metastasis noted. Conclusion: the current case will add to the knowledge of pathologists, gynecologists and oncologists thereby helping in an early diagnosis and better management of sarcomatous transformation in the mature cystic teratoma.

Laparoscopy in Pregnancy: Dermoid Torsion in the Second Trimester

Objective: Demonstration of safe and effective laparoscopic management of ovarian torsion secondary to a large dermoid cyst in the second trimester of pregnancy.

The Appropriate Surgical Approach to Frontotemporal Dermoid Cysts in Adult Patients.

Because frontotemporal dermoid cysts are superficial masses on the zygomaticofrontal suture, they are usually removed by simple direct excision in pediatric patients. Adult patients, however, require a more involved treatment approach because these cysts may be large and extend deeply into the surrounding tissue. From 2008 to 2015, 33 adult patients with frontotemporal dermoid cysts were treated in our clinic under a new treatment algorithm. Patients with a cyst smaller than 2 cm in diameter were treated using a direct excisional approach without a preoperative computed tomography (CT) evaluation. Patients with a cyst larger than 2 cm in diameter underwent a preoperative CT evaluation to determine the exact location of the cyst. If the cyst invaded the temporal fossa, a hemicoronal approach was used for excision. Cysts that did not cross the lateral orbital rim were removed using a direct excisional approach. Among the 33 patients in the study, 6 patients had cysts smaller than 2 cm in diameter, and 27 patients had cysts larger than 2 cm in diameter. Of the 27 patients with large dermoid cysts, 17 cysts showed temporal fossa invasion and 10 showed no signs of temporal fossa invasion. In all cases, the cyst was completely excised without rupture, and no instances of complications or recurrence were observed. In adults with frontotemporal dermoid cysts larger than 2 cm in diameter, preoperative CT evaluations should be performed. If the evidence suggests that a cyst has invaded the temporal fossa, a hemicoronal approach is required for complete excision.

Large Sublingual Dermoid Cyst in the Floor of Mouth and Submental Space

A dermoid cysts are benign congenital lesions of ectodermal origin not commonly seen in the mouth, however when presents as a swelling in the middle of the mouth floor and its developmental lesion usually due to retention of germinal epithelium during growth of branchial arches and Lower jaw. Usually diagnosed during the 2nd and 3rd decade of life and rarely seen in children. This is a case of 13 years old boy was presented with firm painless swelling in the floor of mouth extending into the submental space, dermoid cyst should be considered in the differential diagnosis as one of the lesions presented in any midline swelling. The main treatment is surgical excision using an intraoral approach to avoid scar extra-orally.

Large Dermoid Cyst of Floor of Mouth : A Case Report

Large Dermoid Cyst of Floor of Mouth : A Case Report

Laparoendoscopic Single-Site Surgery for Large Dermoid Cyst: Surgical Technique Modifications

Abstract Introduction: With the advent of laparoendoscopic single-site surgery (LESS) techniques emerging as viable, feasible, and widely applicable minimally invasive procedures,1–8 it is likely that its role in gynecologic surgery will be increasingly recognized. Numerous studies9–14 have shown that LESS can help to improve cosmesis and potentially reduce postoperative pain. We aim to describe our surgical technique to carry out the LESS approach through transumbilical access to remove a large dermoid cyst of the ovary in a patient who had subsequent melanoma excision and skin grafting at the interscapular region. The video run time is 6 minutes 34 seconds. The video includes the surgical procedure using our modified technique, the postoperative surgical scar, and the comparison of our surgical technique with the conventional cystectomy surgical technique. Materials and Methods: The patient is a 35-year-old Caucasian lady who underwent a two-step surgery to remove (1) a large 100×77×90mm right-sided der...