Dr. Dean

What Should Be Done About My Daughter's Dermoid Cyst ?

Posting Date: 05/18/2001

Lee: I have a 20-month-old-daughter who has a bump on her right eye. We first noticed it when she was about a year old. It?s right on the corner of the eyelid. It isn?t red or inflamed. For several months the pediatrician just thought it was a cyst, but then it never went away and we finally went to a pediatric ophthalmologist. They said it was a dermoid cyst.

The doctor wants to have it removed. I have a surgery scheduled over the next couple of months because it is noticeable at this point. They said they were afraid she might bump into something, because she?s very active. They are afraid is might disperse.

Dr. Dean: Okay. My 30-year-old-son had one of these when he was younger. It was in that same location and we eventually had it treated cosmetically. He could do weird things with it, like pop it out and make it look gross.

A dermoid is a very interesting cyst that?s congenital. It?s like skin only turned inside-out. Inside the dermoid can be hair, even teeth, and other things. Dermoids are considered benign. They can grow a little and they can occur everywhere in the body.

I?ll tell you a funny story. People think I?m making this up. There is a case in a medical journal, I have it in my files, of a gynecologist who actually was doing a Pap-smear on a woman and he saw teeth looking back at him. That?s not a place in the body you expect to see teeth, despite all the jokes. This woman had a dermoid, which can also occur in the pelvic region. It had teeth in it and it had erupted next to her cervix.

So, if it?s a dermoid there isn?t much to do about it. If it?s noticeable, it?s the kind of thing you may want to remove, but only let an expert do it. This is something an ophthalmological plastic surgeon should take care of because the eyelids are tricky. Obviously you wouldn?t want a pediatrician to tackle it.

There should not be a noticeable scar when she matures. The incision, if operated on appropriately, should be covered by the folds of skin at the corner of the eyelid. And it?s not an emergency. That?s why they?re letting you wait to do it whenever you want.