Laparoscopic management of dermoid cysts in patients of reproductive age.

OBJECTIVE: Ovarian dermoid cysts are one of the most common germ cell tumors in women. The aim of the study was to analyze the use of laparoscopy in dermoid cysts treatment in women of reproductive age.

MATERIAL AND METHODS: The studied material consisted of 95 patients, aged 17-49, operated on because of dermoid cyst suspicion at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, in the years 1996-2005. All the patients had pre-operative CA-125 antigen evaluation and transvaginal sonography with Doppler assessment of the ovarian pathology. All the women with tumors less than 8 cm in diameter were qualified for laparoscopic management.

RESULTS: The majority of patients were below 40 years of age (86 women; 90.5%). Out of 95 studied cases, 93 (97.9%) had the cyst removed during laparoscopy, mostly elective. Dermoid cyst enucleation was the most commonly applied procedure, while oophorectomy was the least frequent. The whole gonad was removed in 33 patients (34.7%), generally because of the total loss of functional ovarian tissue surrounding the cyst (28 women; 29.5%). All the extracted material was submitted for a histopathological examination--the diagnosis of mature ovarian cystic teratoma was confirmed in 100% of cases. The correspondence of pre-operative sonographic imaging and intraoperative macroscopic assessment was evaluated. In 85 (89.5%) operated patients an ovarian tumor was earlier described as a dermoid cyst.

CONCLUSIONS: Laparoscopic treatment of ovarian dermoid cysts is a safe method, offering many advantages in comparison to classical surgery. However, proper early qualification, based on medical history, gynecological and sonographic examination is of great importance.