Monday, September 03, 2012

A dermoid cyst - is it your lost twin or not?

I have had a Google Scholar alert out for "dermoid cyst" for 6 months and hundreds of web pages have been emailed to me since. None of them mention the possibility that a dermoid cyst is a lost twin.

However, chase this term around the net and BINGO! There are all kinds of peope talking about this possibility, not least on this blog.

Here is one such:

Dermoid Cysts on Ovaries: Your Lost Twin

Everyone knows that cysts are normal (sometimes abnormal) masses that grow inside the body. Most of them sort themselves out in the long run, while others need a bit more persuasion. There are some cysts, however, like dermoid cysts on ovaries, that seem like characters straight out of a Stephen King novel, or an Alfred Hitchcock movie, if you will.

The Stranger Within

In medicine, a theory has been postulated that about as much as eighty per cent of the population start out as twins. During the developmental stage of these fetuses, one fetus overcomes and absorbs the smaller and weaker twin. In most cases, the weaker twin is fully absorbed in the developing stronger twin. In some, the “absorbed twin” somehow continues to develop in the “absorbing twin” in bits and pieces and in whatever part of the body that he/she has been absorbed to. These growths are then called dermoid cysts, and may grow anywhere from a person’s brain, to the inside of the leg muscles, and even in the ovaries.
Dermoid cysts on ovaries may not be aliens from outer space, but they are aliens to your body. Dermoid cysts on ovaries, more often than not, turn out to be something to be scared about. Dermoid cysts are cysts with a solid interior which contain mature tissue that may include skin complete with hair follicles, hair, sebum, blood, fat, nails, teeth, cartilage, eyes, and other tissues. Suffice to say, having dermoid cysts on ovaries is eerily like having parts of another person in your ovaries.

The Stranger May Be Hostile
The good news is dermoid cysts on ovaries, like in many cases of dermoid cysts, are usually benign. Once dermoid cysts on ovaries are detected, however, the usual course of action – regardless if it is, in fact, benign – would be to remove the cysts immediately. Dermoid cysts on ovaries, though very rarely cancerous, may become of such size that they are painful and obstructive to other organs, as well as have the possibility of rupturing or twisting in itself. It goes without saying that these possibilities make dermoid cysts on ovaries dangerous.
The removal of dermoid cysts on ovaries during pregnancy is still under debate, however, with the balance of the life of the fetus and the possibility of malignancy on opposing sides of the scale. Dermoid cysts on ovaries also present many dangers to the developing fetus, such as pressure, pre-term labor, or even abortion. Should the size go beyond 6 centimeters in diameter and the classification (benign or malignant/cancerous) of the dermoid cyst on ovaries conclude in the necessity of its removal, the entire cyst should be removed right away as this type of cyst has a tendency to recur.
Surgery is preferably done during the fourth to the sixth month (second trimester) of pregnancy. Removal of dermoid cysts on ovaries may be done through laparotomy (open surgery) or the less invasive laparoscopy (small incision). These have generally led to successful deliveries after the surgery.
 This raises an important question:  if a dermoid cyst is an absorbed twin and if that twin had different DNA that could trigger an immune system reaction. If its an identical twin perhaps the immune reaction is absent or minimal at worst. Does that explain why only some of these cysts are cancerous?

Is there a link between demoid cysts and cancerous tumours?  There does seem to be. Are the experts asking the right questions here?

What do you think?


  1. I had ovarian cysts in my 30's. I would get sharp, stabbing pains. Sometimes I would get very watery blood discharge. I had an ultrasound and they said that's what it was and they were not large or dangerous enough to operate on. I am sure that I absorbed my identical twin.

    1. Its interesting that they said the identical twin was not dangerous. I do wonder if, for some reason, the stem calls from a non-identical twin get lodged in the body of the survivor that these are the "dangerous" ones....

  2. Do DZ twins always have their own amniotic sac? If so, I'm curious as to how the remains of a non-identical twin could be lodged in the other at all. Would that not involve the rupture of both sacs?

    1. There is so much we don't know! My friend a histologist says that stem cells are too big to cross the placental barrier, so this must be some kind of merging at the very earliest stage of embryo development at the morula stage, even before the sacs are formed. There have been DNA tests on dermoid cysts and teratomas and not all of them are identical, that's all I know so far. Anyone with any further information please let me know the references! Thanks.

  3. Dr Charles Boklage has a theory that although DZ twins are dizygotic, they're not the product of separate eggs being fertilised. He states that double ovulation in humans has never been witnessed. Although the twins are dizygotic, there is nothing in that to explain how they got that way. There are at least two reasons behind this.

    Firstly, DZ twins tend to have as many developmental issues as MZ twins do- such as spina bifida, cleft pallets, and deformations of the heart. These are related to embryogenesis, not simply sharing a womb. In many cases, the DZ twins are worst off.

    The second reason relates to this article- the fact that 'parts' of one DZ twin can be found in the other. It also goes most of the way to explain chimerism. Both could be a common result if DZ twins resulted from a single fertilisation, and 'splitting' event.

    I know this flies in the face of what is 'known'. However, the author has been an embryologist for 30 odd years, and teaches at university.
    I'd recommend his book 'How new humans are made' for further reading.

  4. Thanks for this comment. I would add to the mix the notion that an unknown number of living DZ twin pairs may actually be two survivors of a multiple pregnancy. That can mean that one of a pair of DZ twins is an MZ womb twin survivor and can carry the characteristic problems of MZ twins, such as midline defects like spina bifida.

  5. True. It really goes to highlight how much about twinning is assumed. It's great to read about professionals questioning the orthodoxy.In much of science, that's the only way of forming a picture of what's really going on.