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a closed sac that develops abnormally in some body structure

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胞嚢(ほうのう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/11 03:22:22」(JST)

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A dermoid cyst is a teratoma of a cystic nature that contains an array of developmentally mature, solid tissues. It frequently consists of skin, hair follicles, and sweat glands, while other commonly found components include clumps of long hair, pockets of sebum, blood, fat, bone, nails, teeth, eyes, cartilage, and thyroid tissue.

As dermoid cysts grow slowly and contain mature tissue, this type of cystic teratoma is nearly always benign. In those rare cases wherein the dermoid cyst is malignant, a squamous cell carcinoma usually develops in adults, while infants and children usually present with an endodermal sinus tumor.^[1]^:781

Location

Due to its classification, a dermoid cyst can occur wherever a teratoma can occur.

Ovarian dermoid cysts

Ovaries normally grow cyst-like structures called follicles each month. Once an egg is released from its follicle during ovulation, follicles typically deflate. Sometimes fluid accumulates inside the follicle, forming a simple (containing only fluid) cyst.^[2] The majority of these functional cysts resolve spontaneously.

While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermal cells. Complications exist, such as torsion (twisting), rupture, and infection, although their incidence is rare. Dermoid ovarian cysts which are larger or present complications might require removal by either laparoscopy or laparotomy (traditional surgery).^[3]^[4]

Large ovarian cyst
Dermoid cyst in vaginal ultrasonography
A complex cyst due to a dermoid as seen on ultrasound
A complex cyst due to a dermoid as seen on CT. Arrow points to bone or teeth.

Periorbital dermoid cysts

Periorbital dermoid cyst in left eyebrow. The cyst was present at birth but was not noticeable at the time.

Dermoid cysts can appear in young children, often near the lateral aspect of the eyebrow (right part of the right eyebrow or left part of the left eyebrow). Depending on the perceived amount of risk, these are sometimes excised or simply kept under observation.

An inflammatory reaction can occur if a dermoid cyst is disrupted, and the cyst can recur if it is not completely excised. Sometimes complete excision is not practical if the cyst is in a dumbbell configuration, whereby it extends through a suture line in the skull.

If dermoid cysts appear on the medial aspect, the possibility of an encephalocele becomes greater and should be considered among the differential diagnoses.

Dermoid cysts develop during pregnancy. They occur when skin cells and things like hair, sweat glands, oil glands or fatty tissue get trapped in the skin as a baby grows in the womb.Dermoid cysts are present at birth (congenital) and are common. It can be months or years before a dermoid cyst is noticed on a child because the cysts grow slowly.

Dermoid cyst symptoms are minor and the cysts are usually painless. They are not harmful to a child’s health. If they become infected, the infection must be treated and the cyst should be removed. It is easier to remove cysts and prevent scars if the cyst is removed before it gets infected.

Spinal dermoid cysts

Spinal dermoid cysts are benign ectopic growths thought to be a consequence of embryology errors during neural tube closure. Their reported incidence is extremely rare, accounting for less than 1% of intramedullary spinal cord tumours. It has been proposed that a possible 180 cases of spinal dermoid tumours have been identified over the past century in the literature.^[5]^[6]

Dermoid cysts more often involve the lumbosacral region than the thoracic vertebrae and are extramedullary presenting in the first decade of life.

Various hypotheses have been advanced to explain the pathogenesis of spinal dermoids, the origin of which may be acquired or congenital.

Acquired or iatrogenic dermoids may arise from the implantation of epidermal tissue into the subdural space i.e. spinal cutaneous inclusion, during needle puncture (e.g. lumbar puncture) or during surgical procedures on closure of a dysraphic malformation.^[6]^[7]
Congenital dermoids, however, are thought to arise from cells whose position is correct but which fail to differentiate into the correct cell-type. The long-time held belief was that the inclusion of cutaneous ectodermal cells occurred early in embryonic life, and the displaced pluripotent cells developed into a dermoid lesion.^[7]^[8]

Spinal abnormalities, e.g. intramedullary dermoid cysts may arise more frequently in the lumbosacral region (quite often at the level of the conus medullaris) and may be seen with other congenital anomalies of the spine including posterior spina bifida occulta as identified by the neuroradiological analysis.^[5]^[8]

Differential diagnosis

A small dermoid cyst on the coccyx can be difficult to distinguish from a pilonidal cyst. This is partly because both can be full of hair. A pilonidal cyst is a pilonidal sinus that is obstructed. Any teratoma near the body surface may develop a sinus or a fistula, or even a cluster of these. Such is the case of Canadian Football League linebacker Tyrone Jones, whose teratoma was discovered when he blew a tooth out of his nose.^[9]

Treatment

Treatment for dermoid cyst is complete surgical removal, preferably in one piece and without any spillage of cyst contents. Marsupialization, a surgical technique often used to treat pilonidal cyst, is inappropriate for dermoid cyst due to the risk of malignancy.

The association of dermoid cysts with pregnancy has been increasingly reported. They usually present the dilemma of weighing the risks of surgery and anesthesia versus the risks of untreated adnexal mass. Most references state that it is more feasible to treat bilateral dermoid cysts of the ovaries discovered during pregnancy if they grow beyond 6 cm in diameter. This is usually performed through laparotomy or very carefully through laparoscopy and should preferably be done in the second trimester.^[10]

References

^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
^ "Mayo Clinic: Ovarian Cysts" https://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=causes
^ "Cyst Management"http://onlinelibrary.wiley.com/doi/10.1002/uog.7610/full#bib2
^ "Dermoid Cyst of the Ovary Defined" http://www.medterms.com/script/main/art.asp?articlekey=2960
^ ^a ^b Najjar et al (2005) Dorsal Intramedullary Dermoids. Neurosurgery Review. 28:320-325
^ ^a ^b Aalst et al (2009) Intraspinal Dermoid and Epidermoid Tumours: Reports of 18 Cases ad Reapproasal of the Literature. Pediatric Neurosurgery. 45:281-290
^ ^a ^b Roth et al (1966) Intramedullary dermoid - Journal of neurology, Neurosurgery and Psychiatry 29:262-264
^ ^a ^b Muraszko et al (2000) Intramedullary spinal tumours of disordered embryogensis – Journal of Neuro-oncology 47:271-281
^ Maki: Jones returns to say goodbye Globe and Mail, November 16, 2006
^ Walid MS; Boddy MG. (2008). "Bilateral dermoid cysts of the ovary in a pregnant woman: case report and review of the literature". Arch Gynecol Obstet. 279 (2): 105–108. doi:10.1007/s00404-008-0695-3. PMID 18509663.

UpToDate Contents

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English Journal

Plasminogen activators are involved in angiostatin generation in vivo in benign and malignant ovarian tumor cyst fluids.

van Tilborg AA1, Sweep FC2, Geurts-Moespot AJ2, Wetzels AM1, de Waal RM1, Westphal JR1, Massuger LF1.Author information 1Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.2Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.AbstractIn many tumor types, angiogenesis is the net result of pro- and anti-angiogenic mediators and correlated with metabolic activity, growth, and degree of malignancy. One of the first discovered anti-angiogenic compounds is angiostatin, a proteolytic fragment of plasminogen. The requirements for in vivo angiostatin generation have not yet been determined. We investigated the levels of plasminogen and angiostatin by western blotting and of components of the plasminogen activator complex by ELISA in cyst fluid derived from benign and malignant ovarian tumors. Fluid samples from functional ovarian follicles, dermoid cysts and endometriotic lesions were evaluated separately. When no or minimal amounts of plasminogen were present in the cyst fluids, angiostatin was generally absent as well, irrespective of plasminogen activator concentrations. When plasminogen was present, the degree of conversion of plasminogen to angiostatin was significantly correlated with the level of uPA, and, to a lesser extent, to the tPA level. However, angiostatin was also found in a number of cyst fluid samples with minimal or no plasminogen activators, suggesting the involvement of other angiostatin generating proteases in these samples. Conversely, no angiostatin was observed in a number of cyst fluid samples containing both plasminogen and plasminogen activators. The presence of an inhibitor of the enzymatic activity of uPA and/or tPA, like PAI-1, may explain this finding. Our data show that plasminogen activators are clearly involved in in vivo angiostatin formation in ovarian cysts. Most likely, however, other proteases, as well as inhibitors of plasminogen activators, are involved as well.
International journal of oncology.Int J Oncol.2014 Apr;44(4):1394-400. doi: 10.3892/ijo.2014.2303. Epub 2014 Feb 14.
In many tumor types, angiogenesis is the net result of pro- and anti-angiogenic mediators and correlated with metabolic activity, growth, and degree of malignancy. One of the first discovered anti-angiogenic compounds is angiostatin, a proteolytic fragment of plasminogen. The requirements for in vi
PMID 24535412

[Sublingual Dermoid Cyst: A Case Report.]

Tekkeşın MS1, Ozer N, Olgaç V.Author information 1İstanbul Üniversitesi, Onkoloji Enstitüsü, Tümör Patolojisi Bilim Dalı, İSTANBUL, TÜRKİYE.AbstractDermoid cysts are uncommon, benign congenital lesions of ectodermal origin that can occur in any region of the body. They arise from epithelial rests during embryogenesis. Nearly 7% occur in the head-neck region, and they represent less than 0.01 % of all cavity cysts. They are usually diagnosed during the 2nd and 3rd decade of life, and rarely present in children. A case of dermoid cyst in the sublingual region in a 4-year-old female child was presented. The floor of the mouth is the most common location in the oral cavity and should be considered in the differential diagnosis of any midline lesion. Treatment is surgical excision.
Turk patoloji dergisi.Turk Patoloji Derg.2014 Mar 18. doi: 10.5146/tjpath.2014.01236. [Epub ahead of print]
Dermoid cysts are uncommon, benign congenital lesions of ectodermal origin that can occur in any region of the body. They arise from epithelial rests during embryogenesis. Nearly 7% occur in the head-neck region, and they represent less than 0.01 % of all cavity cysts. They are usually diagnosed dur
PMID 24638194

Chiasmal haemorrhage secondary to glioma with unusual MRI appearance.

Arrese I1, Sarabia R2, Zamora T3.Author information 1Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain. Electronic address: iarrese14@yahoo.es.2Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain.3Department of Pathology, Hospital Universitario Río Hortega, Valladolid, Spain.AbstractOBJECTIVE: To report a unique case of haemorrhagic presentation of a chiasmal and optic tract glioma (OPG) appearing as an extra-axial lesion on MRI scans.
Neurocirugia (Asturias, Spain).Neurocirugia (Astur).2014 Mar 12. pii: S1130-1473(14)00021-9. doi: 10.1016/j.neucir.2013.11.001. [Epub ahead of print]
OBJECTIVE: To report a unique case of haemorrhagic presentation of a chiasmal and optic tract glioma (OPG) appearing as an extra-axial lesion on MRI scans.CASE REPORT: A 30-year-old female with a preoperative radiological diagnosis of dermoid cyst was operated. No lesion was found in the chiasmal or
PMID 24630732

Japanese Journal

皮様囊腫の自然破裂症例 : 化学性腹膜炎遷延の予防のために

産科と婦人科 83(1), 91-95, 2016-01
NAID 40020697287

Clinical decision upon resection or observation of ocular surface dermoid lesions with the visual axis unaffected in pediatric patients

SpringerPlus 4, 534, 2015-09-21
NAID 120005663174

ISP-18-5 Case of Parasitic Dermoid Cyst of the Omentum(Group 18 Women's healthcare 3,IS Poster,International Session)

日本産科婦人科學會雜誌 67(2), 1051, 2015-02-01
NAID 110009942216

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リンク元	「皮様嚢腫」「類皮嚢胞」「類皮嚢腫」「類皮嚢胞腫」
拡張検索	「epidermoid cyst」

「皮様嚢腫」

Dermoid cyst
	A small (4 cm) dermoid cyst of an ovary, discovered during a C-section
Classification and external resources
Specialty	Gynecology
ICD-10	D27.9
	[edit on Wikidata]

　　[★]

英: dermoid cyst
同: 類皮嚢胞、皮様嚢腫、類皮腫 dermoid、類皮嚢胞腫
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皮様嚢胞腫 : 約 12,800 件
類皮腫 : 約 20,500 件
皮様嚢腫 : 約 103,000 件
類皮嚢胞 : 約 34,100 件

「類皮嚢胞」

　　[★]

英: dermoid cyst
関: 類皮嚢腫、皮様嚢腫、類皮嚢胞、類皮嚢胞腫、奇形腫

→皮様嚢腫

「類皮嚢腫」

　　[★]

英: dermoid cyst
関: 類皮、類皮嚢胞、皮様嚢腫、類皮嚢胞腫

「類皮嚢胞腫」

　　[★]

英: dermoid cyst
関: 類皮嚢腫、類皮嚢胞、皮様嚢腫

「epidermoid cyst」

　　[★] 類上皮腫、類表皮嚢胞

[Fitz2-1] Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.

[2] "Mayo Clinic: Ovarian Cysts" https://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=causes

[3] "Cyst Management"http://onlinelibrary.wiley.com/doi/10.1002/uog.7610/full#bib2

[4] "Dermoid Cyst of the Ovary Defined" http://www.medterms.com/script/main/art.asp?articlekey=2960

[Najjaret-5] Najjar et al (2005) Dorsal Intramedullary Dermoids. Neurosurgery Review. 28:320-325

[Aalstet-6] Aalst et al (2009) Intraspinal Dermoid and Epidermoid Tumours: Reports of 18 Cases ad Reapproasal of the Literature. Pediatric Neurosurgery. 45:281-290

[Rothet-7] Roth et al (1966) Intramedullary dermoid - Journal of neurology, Neurosurgery and Psychiatry 29:262-264

[Muraszkoet-8] Muraszko et al (2000) Intramedullary spinal tumours of disordered embryogensis – Journal of Neuro-oncology 47:271-281

[9] Maki: Jones returns to say goodbye Globe and Mail, November 16, 2006

[pmid18509663-10] Walid MS; Boddy MG. (2008). "Bilateral dermoid cysts of the ovary in a pregnant woman: case report and review of the literature". Arch Gynecol Obstet. 279 (2): 105–108. doi:10.1007/s00404-008-0695-3. PMID 18509663.

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dermoid cyst