Dermoid cyst

[RNfromMS]

Today I had a patient who was 27 weeks pregnant who presented to L&D on Sunday afternoon for suspicious tracing. She was placed on magnesium sulfate therapy and given betamethasone injections. This morning, as soon as the doctors turned over report at 8 am, they decided that they needed to do a c-section due to repetitive deep variables and late decelerations that had been occurring over the last several hours and did not appear to be getting any better. After delivery of the 1003 gm (2 lb 3 oz) baby boy who was intubated and sent to NICU, they found that the placenta had a 70% abruption. Then as they were beginning to tuck things in for the closure, they noticed a cyst on her right ovary (pt told me later that she knew she had a cyst there, but figured she would have to deal with it later...probably a few years). They decided to go ahead and remove it. It was a dermoid cyst, rather ugly one, about 4-5 cm round. (For those who don't remember this term from school and never dealt with it in practice, it is a bizarre tumor, usually benign, in the ovary that contains a diversity of tissue, teeth, bone, thyroid, etc. It develoops from a totipotential germ cell..a primary oocyte...that is retained within the egg sac which can give rise to all orders of cells necessary to form mature tissues and often recognizable structures such as sebaceous material, neural tissue and teeth.) Ours had a huge wad of hair on top of it (looked like a brillo pad on top) and you could see teeth underneath the outside layer of the cyst. It was so weird looking. Needless to say, we sent it off to pathology along with the placenta for studying.

[Marie_LPN, RN, LPN, RN]

I tell ya, dermoid cysts just gross me out. Anytime we remove one of those, i can't WAIT to pass it off of the field.:stone

[Suebee6]

ew. Freaky looking things arent they!

[soingal]

I had one; was an incidental finding. Somewhere between my three pregnancies, I incurred an incisional hernia. The ct scan used to confirm the hernia spotted a dermoid on my left ovary. My new OB performed a mini-laparotomy on me on 3/22/06. Mine measured at least 4 cm. I didn't have any noticeable signs that this was on my ovary. The doctor preserved my ovary, which I guess is a good thing. From his description, my cyst was "gross." Obviously. Bet that patient was glad they [finally] got rid of it...

[pnhopeful]

Thanks for sharing your story! I had a dermoid on my ovary removed when I was 8 years old (back in 1988) It had begun to wrap around my ovary and I was soooo sick while the docs were trying to figure out what was wrong with me. Anywho, no lap for me They had to remove the ovary along with the dermoid that was the "size of an orange"!!!! Took my tube with it

[soingal]

Thanks for sharing your story! I had a dermoid on my ovary removed when I was 8 years old (back in 1988) It had begun to wrap around my ovary and I was soooo sick while the docs were trying to figure out what was wrong with me. Anywho, no lap for me They had to remove the ovary along with the dermoid that was the "size of an orange"!!!! Took my tube with it

What can I say? I'm a professional patient! heh heh The doc, a conservative guy, didn't seem at first (consult) that my cyst was anything but a functional one. He did, however, have the good sense to order an ultrasound to ensure that I was right on the money. He went through my c section scar(s). The hernia surgery was harder on me than all of my 4 abdominal cuts in the c section area. I have hernia mesh in there, which I'm sure my body was trying to accept. I wore a surgical binder for nearly a month (my hernia surgery took place on 1/10/06). My OB tries reassuring me that it's "uncommon" to get another dermoid after having one, but I am smart enough to know that it, like anything else in this life, can rear its head again. I was fortunate enough to find a great general surgeon and [new] ob whom I hold in the highest respect. He personally contacts me if his staff cannot answer my questions and takes the necessary time during office visits to explain things to me and address my concerns. These dermoid cysts aren't functional ones; they usually do not go away on their own. Many ppl who I've mentioned this to don't understand that my cyst was a true dermoid in that 1) It had no intention of going away on its own. 2) It was a true teratoma in that it was mature and had no pre-cancerous tendencies. Again, my cyst, because it was the size that it was, could not be removed during a laparoscopic procedure. Hoosier P.S. Mine did not contain bones or teeth but did have hair and sebum in it. Yikes!!! My older sister had one and had a major surgery a few weeks before I had my surgery. She didn't know that I was encountering the same problem. Supposedly, she had a 47-lb. "mass" on her ovary (it had to be an ovarian cyst since an OB was the person performing the op), talked the doc into doing a complete hysterectomy, and the doc told her that it could've ruptured at any time, killing her on the spot. She supposedly had gained a lot of weight. Once the bad-boy cyst was taken down, she lost well over 50 pounds...

[lovemyjob]

Supposedly, she had a 47-lb. "mass" on her ovary (it had to be an ovarian cyst since an OB was the person performing the op), talked the doc into doing a complete hysterectomy, and the doc told her that it could've ruptured at any time, killing her on the spot. She supposedly had gained a lot of weight. Once the bad-boy cyst was taken down, she lost well over 50 pounds...

Can you imagine......

Wow

[soingal]

Can you imagine......

Wow

I don't want to imagine it! LOL Mine could've gotten to that point. If I hadn't incurred the hernia, I may have never found out about it. My doc said he doesn't know how long I had mine, either. Said, 'It's been there for a while.' I had my last child in July of 2003 and had an u/s done a few weeks before his birth. I did have a pap test a few months after that. Nothing was evidently seen. After that, due to a job loss, I didn't see an ob/gyn again until this past Jan. 30. Now, my doc (new one) said that when he did the pelvic exam, he felt a pressure but couldn't diagnose 100% on that alone. So, if I hadn't gotten the hernia and just had a routine woman visit performed, I STILL might not have known! Scary, isn't it?? In his notes to my general surgeon, he writes, 'Her exam is limited by her recent [hernia] surgery.' In other words, he couldn't press too hard on my abdomen since it was still swollen from a few weeks earlier...yikes!