Symptoms of Ovarian Dermoid Cysts

Ovarian dermoid cysts (mature cystic teratomas) are usually asymptomatic. When symptoms do occur, they include pain in the lower abdomen or pelvis and a mass that you or your healthcare provider can feel upon examination.

Severe symptoms such as intense pain and fever may be caused by growing cysts or by complications of this condition.

This article will discuss the symptoms and potential complications of ovarian dermoid cysts. It will also provide guidance about when to seek medical help.

Frequent Symptoms

Ovarian dermoid cysts may have no symptoms (asymptomatic). Diagnosis often occurs incidentally during an ultrasound exam or radiological exam for another condition.

Ovarian dermoid cysts that grow in size can cause symptoms. This is most likely to occur in people with ovaries aged 20 to 40. However, people who are younger or older than this age group may also be diagnosed with an ovarian dermoid cyst.

Ovarian dermoid cyst symptoms include:

• Pelvic pain
• Lower abdominal pain
• A palpable mass in the lower abdomen or pelvis

If the cyst grows, it may compress or push on nearby structures, causing symptoms such as:

• Increasing abdominal size
• Problems with urination
• Gastrointestinal discomfort

Rare Symptoms

Ovarian dermoid cysts range in size from tiny to large, with most being less than 1 centimeter to 10 centimeters across (0.4 to 4 inches). Giant ovarian cysts (greater than 15 centimeters or 6 inches) are rare.

Large ovarian dermoid cysts can cause these symptoms:

• Fever
• Vaginal bleeding
• Intense abdominal pain
• Cachexia (unintentional weight loss with muscle wasting)

Complications

Ovarian torsion and ovarian cyst rupture are two serious complications of ovarian dermoid cysts. There is also a small possibility of a cyst becoming cancerous.

Ovarian Torsion

Ovarian torsion is a common complication caused by large ovarian dermoid cysts. Ovarian torsion occurs when an ovary twists around the ligaments and tissues holding it in place. This twisting cuts off the ovary's blood supply. It may also affect the adjacent fallopian tube.

Symptoms of ovarian torsion are:

• Intermittent cramping for days or weeks (caused by twisting and untwisting of the ovary)
• Sudden, severe abdominal or pelvic pain when the ovary completely twists
• Nausea
• Vomiting

Ovarian torsion is a medical emergency that requires immediate surgery to save the ovary. Large ovarian dermoid cysts are often removed surgically so that torsion is less likely to occur.

Ovarian Cyst Rupture

Around 1% to 2% of ovarian dermoid cysts spontaneously rupture (burst open). The cause is usually unknown. While rare, a rupture can become a medical emergency. Ruptured dermoid cysts are often treated surgically.

Ovarian dermoid cysts may rupture in people at any age. However, this complication is most likely to occur in people of reproductive age.

If a dermoid cyst ruptures, it may bleed profusely, causing low blood pressure and potentially dangerous blood loss. It may also spill its contents into the surrounding area, causing peritonitis. Peritonitis is a painful, potentially life-threatening infection.

Ovarian dermoid cysts sometimes rupture during pregnancy. In some instances, ovarian torsion may cause a ruptured cyst. If the cyst undergoes a malignant transformation and becomes cancerous, it may also rupture. Rupture due to malignancy is most likely to occur in postmenopausal people.

Symptoms of ovarian cyst rupture include:

• Severe pain in the lower abdomen
• Heavy vaginal bleeding
• Dizziness or feeling faint
• Low blood pressure
• Accelerated heart rate

Malignant Transformation

Approximately 1% to 2% of ovarian dermoid cysts undergo a malignant transformation (meaning they become cancerous). The risk for malignancy increases with age. Occurrences of malignant transformation in ovarian dermoid cysts are highest in the post-menopausal age group.

Since they contain a variety of tissues, ovarian dermoid cysts can transform into different types of cancer. Squamous cell carcinoma of the ovary is the most common type. Adenocarcinoma, malignant melanoma, and transitional cell carcinoma may also occur.

Symptoms of malignant transformation may include:

• Abdominal distension
• Palpable mass in the abdomen
• Pelvic or abdominal pain
• Weight loss

Most types and stages of these cancers will be treated with surgery and chemotherapy.

When to See a Healthcare Provider/Go to the Hospital

A healthcare provider should assess pelvic or abdominal pain, whether it comes and goes or is constant. You should also see a healthcare provider if you feel a lump or mass in your stomach or pelvis. Seeking medical support for mild or minor symptoms can help you avoid complications, such as torsion.

Symptomatic ovarian dermoid cysts mimic symptoms found in other conditions, so it is important to be assessed by a healthcare provider. These conditions include:

• Diverticulitis (inflammation of outpouchings of the intestines)
• Ectopic pregnancy (a non-viable pregnancy in which the ovum implants outside of the uterus)
• Gastrointestinal cancer
  

If you feel sudden, severe pain in your abdomen or pelvis, or have heavy vaginal bleeding, you may be having a medical emergency that warrants a trip to the hospital.

Summary

Ovarian dermoid cysts often have no symptoms. When symptoms do occur, they include a lump you can feel and pain. Ovarian dermoid cysts sometimes grow large enough to cause complications that require immediate medical support. Larger dermoid cysts are often removed surgically to avoid these complications.

Complications can include torsion (twisting of the ovary), a ruptured cyst, and cancer. Cancer in ovarian dermoid cysts is very rare.

A Word From Verywell

If your healthcare provider identifies that you have an ovarian dermoid cyst, you may feel concerned or worried. Most dermoid cysts in the ovary do no harm. However, let your healthcare provider know your concerns about cyst growth and complications. Together you can decide the best course of action.