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Dermoid Cyst: Outcome Analysis in a Pediatric Referral Hospital
Santiago Montolío-Marzo1, Hugo González-Valdivia2, Estér Casas-Gimeno2
1Clinical Ophthalmology Department, FISABIO Oftalmología Médica (FOM), Valencia, Spain.
Insights
Pediatric dermoid cysts are common benign tumors. Surgical removal is effective, with low recurrence rates and few complications, though complex cases may need a multidisciplinary approach.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Dermato-oncology
Background:
- Dermoid cysts represent the most frequent benign orbital tumors in children.
- These lesions can present with varied clinical manifestations, including aesthetic concerns, lacrimal drainage obstruction, and proptosis.
Purpose of the Study:
- To delineate the management strategies for pediatric dermoid cysts.
- To analyze surgical outcomes, complications, and recurrence rates in a pediatric referral hospital setting.
Main Methods:
- A retrospective review was conducted on 115 pediatric patients diagnosed with dermoid cysts between 2003 and 2019.
- Data collected included patient demographics, cyst location, presenting symptoms, imaging findings, surgical procedures, and post-operative outcomes.
Main Results:
- The study included 115 patients (55.7% female) with a mean age of 39.15 months at surgery.
- Superficial lesions (90.4%) were more common than deep lesions (9.6%). Superior-temporal and superior-nasal quadrants were the most frequent locations.
- Surgical removal was performed in all but one patient, with a 2.6% recurrence rate, only one of which was linked to intraoperative cyst breach.
Conclusions:
- Dermoid cysts are the most common benign periorbital tumors in pediatric patients.
- Imaging is crucial for evaluating atypical, deep, or fixed lesions.
- Surgical excision is the primary treatment, with a multidisciplinary approach beneficial for complex cases, demonstrating low complication and recurrence rates.
Purpose:
To describe the management of dermoid cysts in a pediatric referral hospital.
Methods:
Retrospective review of 115 patients with pathological diagnosis of dermoid cyst in a pediatric referral hospital between 2003 and 2019.
Results:
One hundred fifteen patients, 51 (44.3%) males, and 64 (55.7%) females were retrospectively reviewed. There were fifty-one (44.3%) right eyes and 64 (55.7%) left eyes. Mean age at surgery was 39.15 months (5.6 months-16.4 years). One hundred four (90.4%) lesions were superficial, and 11 (9.6%) were deep. Quadrant location was 63 (54.8%) superior-temporal, 45 (39.1%) superior-nasal, 4 (3.5%) inferior-temporal, and 2 (1.7%) in the nasal inferior quadrant. Most patients only had aesthetic concerns, but 3 (2.61%) showed lacrimal drainage obstruction symptoms, 2 (1.74%) had proptosis, and 1 case spontaneously drained to the cutaneous surface. Imaging was performed in 51 (44.3%) patients. Regarding to their radiodensity, 71.9% had low density content, 28.1% high density, and only 1 patient showed full liquid content; 10.9% showed heterogeneous content; 53.1% showed bone remodeling. Every patient but 1 underwent surgery for a barely accessible asymptomatic retrobulbar cyst. Nine cysts (7.8%) were breached during surgery. Three recurrences were found (2.6%), but only 1 was related to intraoperative breach.
Conclusions:
Dermoid cysts are the most common benign periorbital tumors in the pediatric population. Imaging is required for evaluation of lesions in atypical locations, deep or fixed to underlying tissue. Surgical removal is the gold standard of treatment. Multidisciplinary approach may be required in the most complex cases. After surgery, few complications and recurrences were found in our series.
