DERMOID CYST OF OVARY

Origin: Dermoid cyst arises from the germ cellsarrested after the first meiotic division.

Pathology: Dermoid cyst constitutes about 97 percent of teratomata. Its incidence is about 30–40 percent amongst ovarian tumors. The tumor is bilateral in about 15-20 percent. It constitutes about 20–40 percent of all ovarian tumors in pregnancy. Torsion is the most common (15–20%) and rupture is an uncommon (1%) complication. The chance of malignancy is about 1–2 percent. Squamous cell carcinoma is the commonest.

NAKED EYE APPEARANCES: -

The cyst is of moderate size. The capsule is tense and smooth. On cut section, the content is a predominantly sebaceous material with hair. There may be clear fluid (cerebrospinal fluid) derived from the neural tissues (choroid plexus). There is one area of solid projection called Rokitansky’s protuberance which is covered by skin with sweat and sebaceous glands.

It is here that teeth and bones are found. Histological section should be made from this area. A rare one consists predominantly of thyroid tissue — called struma ovarii, which may be associated with hyperthyroidism.

Microscopic examination

The wall is lined by stratified squamous epithelium; and at places by granulation tissue. The epithelium may be transitional or columnar. The most common tissue elements are ectodermal.

The terminology of ‘dermoid cyst’ is misnomer, as apart from ectodermal element, there may be endodermal and mesodermal tissues as well. Besides dermal components bone, cartilage, neural tissue, thyroid and salivary gland tissues are often present.

STRUMA OVARII AND STRUMAL CARCINOIDS: -

Rarely ovarian teratomas contain a specialized tissue type. Struma ovarii is composed of thyroid tissue. This accounts for less than 3% of mature teratomas. Malignant changes in a struma ovarii is extremely rare. Strumal carcinoids are also rare teratomas.

Primary carcinoid tumors of the ovary account for less than 5% of ovarian teratomas. These tumors may be hormonally active with secretion of serotonin, bradykinin and other peptide hormones from the argentaffin cells as found in gastrointestinal tract or bronchial tissues. Carcinoid syndrome is characterized by episodic facial flushing, abdominal pain, diarrhea and bronchospasm. Metastatic carcinoid tumors are often bilateral. Carcinoid syndrome is more common in metastatic carcinoid than in ovarian primaries.

HOMOEOPATHIC MANAGEMENT OF DERMOID CYSTS OF OVARY: -

Ovarian cyst management with homoeopathic medicines is a holistic approach that treats the main cause behind the problem. Homeopathic medicines are very safe to use among women of all age groups and these treat Ovarian cysts gently without any side effects.

Lachesis muta:- Swelling and pain in the left ovary that gets better during menses, short and scanty menses, and menstrual bleeding that is blackish in colour.

Lycopodium clavatum:- Burning or boring pains may be felt in the ovary. Irregular periods, profuse or Prolonged periods, pain during intercourse and abdominal bloating are the main symptoms.

Colocynthis:- For painful Ovarian cysts. The pain varies in character, ranging from cramping, stitching to tensive.

Apis Mel:- A stinging, sharp, cutting pain from the ovary radiating down the thighs, soreness and tenderness over the Ovarian region.

Pulsatilla:- A tendency of delayed menstruation, menstrual colic, chilliness, vomiting, heavy pressure in the abdomen and lower back, a pressure in the bladder and rectum are the symptoms.