Primary dermoid cysts of the cecum: A systematic review and case report

Cecal dermoid cysts, mature cystic teratomas, are exceedingly rare. They may present with nonspecific abdominal pain and mimic common surgical conditions. We report a pediatric case of cecal dermoid cyst presenting with acute appendicitis and provide a systematic review of all published cecal dermoid cases.

A 14-year-old female presented with 1 day of right lower abdominal pain, nausea, vomiting and anorexia; she had prior vague right-sided pain with an ultrasound 5 years earlier that identified a right iliac fossa cyst, which was not followed up.

Contrast-enhanced computed tomography showed an inflamed appendix with peri-appendiceal fat stranding and an appendicolith, and a separate well-defined hypodense lesion (3.5 × 3.2 cm) at the ileocecal junction. Differential diagnoses included duplication cyst, dermoid cyst, or low-grade mucinous neoplasm.

Diagnostic laparoscopy confirmed acute appendicitis and a distinct cecal mass with enlarged ileocolic lymph nodes. Because malignancy could not be excluded intraoperatively, a laparoscopic oncologic right hemicolectomy with ileocolic anastomosis was performed.

Histopathology demonstrated a benign dermoid cyst and acute suppurative appendicitis with microscopic perforation; 20 reactive lymph nodes were negative. The postoperative course was uneventful and the patient was discharged.

Cecal dermoid cysts are rare and can mimic common pathologies such as appendicitis or ovarian masses. Preoperative diagnosis is challenging; definitive diagnosis requires surgical excision and histopathology. Laparoscopy is a useful diagnostic and therapeutic tool, but oncologic resection may be required when malignancy cannot be excluded intraoperatively.