Definition and Overview

The removal of a cyst refers to any procedure used to remove an abnormal soft tissue growth or pocket of fluid that forms in various parts of the body. There are several types of cyst removal procedures performed depending on the type of cyst, its size, and its location.

Cysts are identified based on the symptoms they commonly present, such as an abnormal growth, some swelling around it, a change in skin color, as well as some pain. Not all these symptoms manifest though, so all abnormal growths should be brought to the attention of a doctor.

Who Should Undergo and Expected Results

Any cyst removal procedure is recommended for patients who have a cyst that is causing bothersome symptoms, such as pain, or those whose cysts have grown to a problematic size. While small and painless cysts are usually left alone while still being continuously observed, most cysts, especially larger ones, are typically treated by removing the growth and testing for malignancy.

Thus, cyst removal may be prescribed for any individual with an existing cyst of any cause, the most common of which are:

  • Blocked ducts, which cause fluid-filled cysts
  • Cell defects, which cause cancerous cysts
  • Popped blood vessel
  • Parasite

A person’s risk of developing a cyst may be affected by genetics, developmental defects, infections, and fluid obstructions or duct blockages. Some examples of the most common cysts include:

  • Arachnoid cyst, or when a person has an abnormal pocket filled with cerebrospinal fluid on the arachnoid membrane that is covering the brain
  • Bartholin’s cyst, or when the Bartholin ducts become blocked and cause a fluid-filled pocket to form on the sides of the vagina
  • Breast cyst, or painful growths on the breast that may indicate an increased vulnerability to breast cancer
  • Ovarian cyst, or a cyst that grows inside a woman’s ovary; these can be either benign or malignant
  • Sebaceous or epidermoid cyst, or a fluid-filled cyst that forms when a pore or hair follicle becomes clogged or infected
  • Dermoid cyst, or an abnormal growth composed of epidermis, hair follicles, and sebaceous glands, giving them a unique appearance due to the presence of hair, skin, and sometimes even teeth
  • Testicular cyst, or fluid-filled pockets of skin that grow in the testicles
  • Thyroid cyst or nodules, or fluid-filled cysts that grow on the thyroid gland
  • Hepatic cyst, or abnormal growths in the liver, majority of which are benign
  • Renal cyst, or those that grow within the kidney, many of which are congenital

A person who complains of a cyst usually first undergoes a biopsy to determine whether the lump is cancerous or not.

If a cyst is found to be benign, the patient and doctor can discuss whether to proceed with the removal or wait and see whether the cyst will grow bigger or cause symptoms in the future. If symptoms such as pain occur, the cyst will be checked for signs of an infection, such as pus filling up the cyst. In such cases, the removal of the cyst becomes necessary to eliminate the risk of an abscess bursting inside the body and poisoning the blood. If so, the cyst can be surgically removed.

If a cyst is found to be malignant, the treatment usually begins by surgically removing the cyst followed by a treatment plan that will depend on the size and location of the cyst, and staging of the cancerous growth. Cancerous growths are surgically removed along with the tissue immediately surrounding them. However, surgical cyst removal alone is not enough, as patients who have had malignant cysts removed still need to undergo chemotherapy or radiotherapy to completely kill the cancer cells that may still be present in the body.

How Does the Procedure Work?

The method of cyst removal typically depends on the size, location, and type of cyst involved. Fluid-filled cysts, for example, can be drained of their contents, while cysts made up of tissues need to be surgically excised.

There are currently many surgical cyst removal techniques available, such as:

  • Minimal excision – Minimal surgical excisions are less invasive cyst removal techniques when compared to complete excisions. This technique involves compressing the cyst so that it can pass through an incision that is only 2 to 3 mm wide. Since the incision is too small, this technique does not require sutures to close the wound. However, this is not suitable for all types of cysts, especially inflamed ones, because they cannot be easily compressed. In such cases, doctors advise a period of waiting to allow the inflammation to subside before the removal is performed.

  • Laparoscopic or keyhole surgery – Most surgical procedures nowadays already have their laparoscopic counterparts. Known as keyhole surgery, laparoscopy promises smaller incisions, less pain, and shorter recovery periods, making them the surgical technique of choice as long as the patient’s condition allows such a technique. This non-invasive method of cyst removal is highly effective and can remove cysts from most locations. It involves making small incisions and inserting a laparoscope through them; a laparoscope is a long thin tube that has a camera attached to it to allow the doctors to see the inside of the patient’s body. Surgical instruments used to remove the cyst are also inserted through the scope, and the surgery itself is done from outside of the patient’s body.

  • Complete surgical excision, or an open surgery – This uses a traditional open surgery technique featuring a large incision to take out an abnormal growth. This type of excision requires general anesthesia, which means the patient will be asleep throughout the procedure.

  • Laser-assisted cyst removal – A more recently developed cyst removal technique uses laser technology to make a small incision in the cyst itself to drain its content, after which the cyst wall is removed through minimal excision. This technique can remove even large cysts, but it is only suitable for cysts that are not infected, as bursting an infected cyst may make the patient vulnerable to blood poisoning.

Possible Risks and Complications

Any surgery comes with certain risks and a potential for complications. The risks may include:

  • Bleeding
  • Blood clots
  • Infection
  • Pain
  • Scarring, either externally or internally
  • Recurrent cysts
  • Infertility (ovarian or testicular cyst removal)
  • Organ damage

A person’s risk of experiencing complications following the surgical removal of cysts tend to increase if he or she is:

  • Obese
  • Suffering from a chronic illness
  • A heavy drinker
  • A smoker
  • A drug user
  • Pregnant

To avoid post-surgical complications, patients are advised to watch out for signs of an infection and to avoid strenuous activities for 3 to 6 weeks after the surgery; conventional open surgery excisions take longer recovery times. Any untoward symptoms should be reported to the doctor immediately.

References:

  • Nicolai P, Castelnuovo P. Benign tumors of the sinonasal tract. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 49.

  • Warren FM III, Shelton C, Wiggins RH III. Neuroradiology of the temporal bone and skull base. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 135.

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