Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture.

Laparoscopy is the standard method for the diagnosis and treatment of ovarian dermoid cysts, which represent 10% to 15% of all ovarian tumors. This procedure offers many advantages including less postoperative pain, lower risk of wound complication, early ambulation, and more rapid convalescence. The risk of adhesion formation also is reduced. However, in the case of an ovarian dermoid cyst, the laparoscopic approach could result in chemical peritonitis caused by the spilled contents of a ruptured dermoid cyst. We report a case of chemical peritonitis after rupture of an ovarian dermoid cyst during laparoscopy. Two operations were required, and medical treatment was not beneficial. We discuss a possible new medication for the treatment of this complication and compare this case with other recent reports.

[Sentinel lymph node biopsy in breast cancer: feasibility study and initial experiments]. / Le ganglion sentinelle dans le cancer du sein: étude de faisabilité et expérience initiale.

OBJECTIVE: To evaluate and accredit the sentinel lymph node biopsy in the surgical treatment of breast cancer in our institute. PATIENTS AND METHODS: From February to September 2001 at Tenon Hospital, 64 patients with breast cancer and clinically negative node underwent sentinel lymph node biopsy followed immediately by standard axillary dissection. Both blue dye and radioisotope were used in the majority of patients (70.4%) to identify the sentinel node. These sentinel nodes were evaluated by hematoxylin and eosin, immunohistochemistry and multiple sections. RESULTS: The mean tumor diameter was 17.2 mm (range, 7 to 40 mm). The sentinel node was identified in 97% of the cases (62/64). Of the 62 patients, 24 were histologically positive (38.7%). The sentinel node was falsely negative in one patient (4%). In patients with tumors less than 20 mm, the identification and false negative rates were 97.8% and 0%, respectively. CONCLUSIONS: Our study confirms the validity of the sentinel lymph node. This procedure identifies in a reliable way the sentinel node in most cases. The histological characteristics of the sentinel node reflect those of the rest of the axillary lymph nodes. This procedure appears more accurate for patients with tumors less than 20 mm. This procedure will become the method of choice for axillary staging in small-sized breast cancer. This minimally invasive procedure represents a major step in the field of breast cancer treatment.