Comparison of dermoid cyst and torsioned dermoid cyst

Objective: The aim of this study is to compare Torsion of Dermoid Cysts with Dermoid Cysts in our clinic, in order to identify the reasons for torsion and to facilitate the prediction of torsion in the presence of these risk factors. Materials and Methods: Data of torsioned dermoid cysts and non-torsioned dermoid cysts between April 2010, and April 2023, were retrospectively collected from patient records and electronic databases in our clinic. The study population included patients aged between 12 and 45 years. Data from 150 patients meeting the study criteria were recorded, including demographic information, gynecological history, pregnancy status, diameters of non-torsioned dermoid cysts, diameters of torsioned dermoid cysts, bilateral/unilateral status, the direction of cyst torsion, and the number of torsions. Tumor marker results, leukocyte count, type of surgery, incision method, length of hospital stay, and anesthesia type were evaluated. SPSS 27.0 was used for statistical analysis, and p-values less than 0.05 and 0.01 were considered significant. Findings: In our study, the rate of vascularization observed in the ultrasound of torsioned dermoid cysts was significantly lower (37%) than that in non-torsioned dermoid cysts (100%) (p<0.001). Among the patients with torsioned dermoid cysts, 18.9% were pregnant, while there were no patients operated for dermoid cyst during pregnancy in the non-torsioned dermoid cyst group, showing a significant difference between the groups (p<0.001). A negative correlation was observed between age and CA 19-9. A positive correlation was found between ovarian size and CA 125. A positive relationship was also observed between CA 125 and CA 19-9 and CA 15-3. The mean age of the torsioned dermoid cyst group was 30.4±11.0 years, while the mean age of the non-torsioned dermoid cyst group was 27.0±7.2 years, with no significant difference between them (p=0.091). Conclusion In our study, when torsioned dermoid cysts were compared with nontorsioned dermoid cysts, we identified age, localization of the dermoid cyst, and risk factors for torsion. The mean age of the torsioned group was 30.4±11.0 years, while the mean age of the non-torsioned dermoid cyst group was 27.0±7.2 years. It was observed that ultrasonographic vascularization of torsioned dermoid cysts was most frequently disrupted in the right ovary, and a positive correlation with tumor markers was found as ovarian size increased. Keywords: Dermoid Cyst, Torsioned Dermoid Cyst, Tumor Marker, Pregnancy