Ovarian Dermoid Cyst: Symptoms, Causes, Diagnosis, and Treatment
Updated: 1 hour ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR: An ovarian dermoid cyst, also known as a mature cystic teratoma, is a benign fluid-filled sac that contains mature tissues such as skin, hair, and teeth. Unlike typical ovarian cysts, these form from germ cells before birth rather than in response to the menstrual cycle. While usually harmless, large cysts can lead to complications like ovarian torsion or rupture, necessitating surgical removal.
Quick answer: An ovarian dermoid cyst is a slow-growing, non-cancerous tumor that develops in the ovaries. It is unique because it contains fully developed tissue from various parts of the body, most commonly skin, hair, and teeth, but occasionally even nerve or brain tissue. These cysts form from germ cells (the same cells that become eggs) when the three primary layers of fetal development (ectoderm, mesoderm, and endoderm) grow atypically.
These cysts are the most common type of benign ovarian germ cell tumor and are frequently discovered during routine imaging, such as a pregnancy ultrasound. While they do not disappear on their own, they only require treatment if they grow large enough to cause symptoms or pose a risk of complications. Complications include ovarian torsion (twisting of the ovary) or rupture, both of which may require emergency medical attention. Surgery, typically via laparoscopy, is the primary treatment and is highly effective, with a very low recurrence rate.
Symptoms of Ovarian Dermoid Cysts
Most ovarian dermoid cysts are asymptomatic and remain undetected until routine medical imaging. However, larger cysts can cause physical discomfort.
Common Symptoms
Abdominal pressure: A feeling of fullness or pressure in the lower abdomen.
Pain: Persistent or intermittent aching in the pelvic region.
Digestive issues: Nausea, vomiting, or constipation.
Intercourse pain: Painful intercourse (dyspareunia).
Appetite changes: Feeling full quickly or noticing changes in eating habits.
Warning: Seek immediate medical care if you experience excruciating abdominal pain, high fever, dizziness, or fainting, as these may indicate a ruptured cyst or ovarian torsion.
Causes and Development
Ovarian dermoid cysts form before birth due to atypical growth of germ cells.
The Role of Germ Cell Layers
Germ cells contain three layers that are responsible for forming every tissue in the body:
Ectoderm: Skin, hair, sweat glands, teeth, and nerves.
Mesoderm: Muscle, bone, and connective tissue.
Endoderm: The gut and various internal organs.
In a dermoid cyst, these layers develop into mature tissue in an abnormal location. Sweat glands within the cyst can secrete an oily fluid called sebum, which causes the cyst to grow slowly over time, particularly during reproductive years.
Potential Complications
While less than 2% of these cysts become cancerous, they can cause significant physical issues if they grow too large.
Ovarian Torsion
A large cyst can cause the ovary to twist out of its normal position. This twisting cuts off blood supply and can lead to the death of the ovarian tissue if not treated promptly.
Cyst Rupture
If a cyst bursts, its contents (including sebum and hair) leak into the abdominal cavity. While the body often absorbs these contents, it can sometimes lead to severe infection or inflammation.
Cancer Risk Factors
The risk of a dermoid cyst becoming malignant (cancerous) increases if:
The patient is over age 45.
The tumor is growing rapidly.
The cyst diameter exceeds 10 centimeters.
Diagnosis and Testing
Because they are often silent, ovarian dermoid cysts are usually incidental findings.
Ultrasound: The primary tool; sonographers can identify these cysts with nearly 100% accuracy due to their distinctive appearance.
MRI: Used if ultrasound results are unclear to provide a more detailed look at the cyst's composition.
Routine exams: Often discovered during prenatal ultrasounds or regular pelvic check-ups.
Treatment and Surgical Options
Treatment is recommended for cysts that are large (typically over 5 centimeters), symptomatic, or at risk of complications.
Surgical Procedures
Ovarian cystectomy: The cyst is removed while preserving as much of the ovary as possible. This is the preferred method for those wishing to maintain fertility.
Oophorectomy: The entire affected ovary is removed along with the cyst.
Laparoscopy: "Keyhole surgery" involving small incisions; the most common method for removal.
Laparotomy: A larger abdominal incision used for very large cysts, cysts on both ovaries, or suspected malignancy.
Conclusion
Ovarian dermoid cysts are unique biological occurrences that, while often sounding alarming due to their contents, are overwhelmingly benign. Most individuals can live with them under medical monitoring, but surgical removal offers a permanent cure with a recurrence rate of only 3% to 4%.
Call to Action
If you have been diagnosed with an ovarian cyst or are experiencing persistent pelvic pressure, consult with your OB/GYN to discuss whether imaging is necessary to rule out a dermoid cyst or other complications.
Frequently Asked Questions
Is an ovarian dermoid cyst a twin or a baby?
No. It is a collection of mature tissue that forms from germ cells growing atypically; it is not a fetus or a pregnancy.
Can these cysts disappear on their own?
No. Unlike functional ovarian cysts, dermoid cysts do not resolve without surgical intervention.
Why do they contain hair and teeth?
They form from germ cells, which have the genetic "blueprints" to create any tissue in the body. In these cysts, those blueprints are activated abnormally.
Are ovarian dermoid cysts cancerous?
Over 98% are benign. The risk of cancer is very low but increases with age and the size of the cyst.
How fast do they grow?
They grow very slowly, usually about 1.8 mm per year, with most growth occurring during the reproductive years.
Can I still get pregnant after having one removed?
Yes. In most cases, surgeons can perform a cystectomy, which removes the cyst while leaving the healthy part of the ovary intact.
Are they present at birth?
Yes, they are thought to be present from birth but are often not discovered until adulthood or during pregnancy.
Can I have a dermoid cyst in both ovaries?
Yes, about 10% to 15% of cases involve cysts in both ovaries.
What is a "mature cystic teratoma"?
It is the medical term for an ovarian dermoid cyst. "Mature" refers to the fact that the tissues inside are fully developed.
What happens if a dermoid cyst ruptures?
It can cause sudden, severe pain and potentially lead to an infection in the abdominal cavity, requiring immediate medical care.
Is surgery always necessary?
No. Small, asymptomatic cysts may simply be monitored with regular ultrasounds.
What is ovarian torsion?
It is a medical emergency where a cyst causes the ovary to twist, cutting off its blood supply.
Can a dermoid cyst be diagnosed without surgery?
Yes, they have a very distinctive appearance on an ultrasound that makes them easy for specialists to identify.
What is the recovery time for laparoscopy?
Most people can return to normal activities within a few weeks after keyhole surgery.
Do dermoid cysts grow back?
It is rare; they recur in only about 3% to 4% of cases after surgical removal.
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Medical Disclaimer
This content is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here. If you think you may have a medical emergency, call your doctor or 911 immediately.
Source date: August 4, 2022.
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