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Updated: May 23, 2025
In a case of Sangster, reported by Politzer, although most of the dermoids, as usual, were like fibroma-nodules and therefore the color of normal skin, those over the mastoid processes and clavicle were lemon-yellow, and were generally thought to be xanthoma until they were excised, and Politzer found they were typical dermoid cysts with the usual contents of degenerated epithelium and hair.
Although dermoids are of congenital origin, they are rarely evident at birth, and may not give rise to visible tumours until puberty, when the skin and its appendages become more active, or not till adult life. Superficial dermoids, such as those met with at the outer angle of the orbit, form rounded, definitely limited tumours over which the skin is freely movable.
Dermoids are found in the palate and pharynx, and open dermoids of the conjunctiva are classified by Sutton with the moles. According to Senn, Barker collected sixteen dermoid tumors of the tongue. Bryk successfully removed a tumor of this nature the size of a fist. Wellington Gray removed an enormous lingual dermoid from the mouth of a negro. It contained 40 ounces of atheromatous material.
Dermoids of the rectum are reported. Duyse reports the history of a case of labor during which a rectal dermoid was expelled. The dermoid contained a cerebral vesicle, a rudimentary eye, a canine and a molar tooth, and a piece of bone. There is little doubt that many cases of fetus in fetu reported were really dermoids of the scrotum.
If the external orifice becomes occluded, there results a dermoid cyst. Tubulo-dermoids arise from embryonic ducts and passages that are normally obliterated at birth, for example, lingual dermoids develop in relation to the thyreo-glossal duct; rectal and post-rectal dermoids to the post-anal gut; and branchial dermoids in relation to the branchial clefts.
Dermoids more deeply placed, such as those within the thorax, or those situated between the rectum and sacrum, give rise to difficulty in diagnosis, even with the help of the X-rays, and their nature is seldom recognised until the escape of the contents particularly hairs supplies the clue.
CLASSIFICATION OF TUMOURS: I. Connective-tissue tumours: Innocent: Lipoma, Xanthoma, Chondroma, Osteoma, Odontoma, Fibroma, Myxoma, Endothelioma, etc.; Malignant: Sarcoma II. Epithelial tumours: Innocent: Papilloma, Adenoma, Cystic Adenoma; Malignant: Epithelioma, Glandular Cancer, Rodent Cancer, Melanotic Cancer III. Dermoids IV. Teratoma.
Tubulo-dermoids present the same structure as skin dermoids, save that mucous membrane takes the place of skin in the wall of the cyst, and the contents consist of the pent-up secretion of mucous glands. Clinical Features.
The literature of dermoid cysts is full of accounts of puzzling tumours met with in all sorts of situations. The treatment is to remove the cyst. When it is impossible to remove the whole of the lining membrane by dissection, the portion that is left should be destroyed with the cautery. Ovarian Dermoids.
The so-called "orbital wens" are true inclusion of the skin of a congenital origin, as are the nasal dermoids and some of the cysts of the neck. Weil reported the case of a man of twenty-two years who was born with what was supposed to be a spina bifida in the lower sacral region.
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