OVARIAN DERMOID CYSTS

The adjective dermoid should be applied to cysts of the ovary when they contain skin or mucous membrane. Frequently dermoids contain both these structures.

The amount of skin in a dermoid varies greatly in different cysts, and in the complexity of the cutaneous appendages with which it may be furnished. In some specimens the wall of a large cyst will be completely covered with skin, whilst in others it will be restricted to a small area, or even be confined to a small loculus in a multilocular cyst.

The following cutaneous appendages have been found in ovarian dermoids:—Hair, sebaceous glands, sweatglands, teeth, mammae, horn, nail, bone, unstriped muscle and tissue histologically identical with brain matter. The hair of dermoids varies in length, colour, and amount. A single tuft coiled into a ball and mixed with sebaceous matter is not infrequent, and may attain a length of twenty inches. Munde* has described and figured a specimen in which a tuft of hair in an ovarian dermoid was five feet long. Occasionally only a few hairs are found scattered on the cyst wall, or the hair may be rolled into balls and lie free in the cyst. The colour is equally capricious, and, as a rule, differs from that on the exterior of the individual.

The hair in such cysts changes in colour with age, and in elderly persons becomes quite white, and is eventually shed, so that these cysts become actually bald. Sebaceous glands are numerous and very large in size. Occasionally they become converted into retention cysts. Sweat glands are not so frequent as the sebaceous variety, and generally occur in clusters. The pultaceous material which fills these cysts is a mixture of epithelial debris, sebum from the sebaceous glands, shed hairs, oil, and cholesterine. Unistriped iiiusde fibre is frequently found in the wall of ovarian dermoids, but the striped variety is very rare. Bone is often present, either in loose, ill-formed, and shapeless masses, resembling in structure that found along the alveolar borders of the jaws, or as irregular plates, exceedingly hard, and resembling, as Doran suggests, the facial bones of an osseous fish.