[Perforated mesenteric cyst causing abdominal pain in a 12-year-old girl].

In this case report, a 12-year-old girl was admitted to hospital due to abdominal pain. An intra-abdominal mass was seen on ultrasound and initially mistaken for an ovarian cyst. Later, a CT scan was performed, and it revealed an intraperitoneal cystic mass compatible with a mesenteric cyst, which is a rare benign abdominal abnormality. The cyst was removed by laparotomy, and histology confirmed the diagnosis. The patient had no readmissions afterwards.

Shoulder disability and late symptoms following surgery for early breast cancer.

INTRODUCTION: Axillary dissection in combination with radiation therapy is thought to be the main reason why patients surgically treated for breast cancer may develop decreased shoulder mobility on the operated side. The surgery performed on the breast has not been ascribed any considerable importance. In order to evaluate the influence of the surgical technique and the adjuvant oncological therapy on the development of shoulder morbidity, we assessed the physical disability in 132 breast cancer patients with a median follow-up time of 3 years after surgery. METHODS AND METHODS: Eighty nine (67%) patients had been subjected to modified radical mastectomy and 43 (33%) to breast conserving therapy (BCT). All patients had axillary dissection of level I and II. The shoulder function was assessed by the Constant Shoulder Score including both subjective parameters on pain and ability to perform the normal tasks of daily living, and objective parameters assessing active range of motion and muscle strength. RESULTS: Shoulder disability seems to be a frequent late complication to the treatment of early breast cancer (35%). When equal axillary dissection and radiation therapy had been applied, BCT patients were found to suffer less frequent from this complication than patients treated with mastectomy.

The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer: a randomized study.

The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer was examined through a randomized controlled trial. One hundred and thirty-nine patients with newly diagnosed breast cancer were enrolled in the study. Sixty-two (45%) had Breast Conserving Therapy and 77 (55%) had Modified Radical Mastectomy (Axillary dissection of level I and II was included in both procedures). Enrolled patients were randomized to either group A or group B. Group A was offered, team instructed physiotherapy consisting of 12 sessions of 60 min, two sessions a week. The treatment was instituted between the sixth and eight postoperative week. Group B was also offered team instructed physiotherapy, consisting of 12 sessions of 60 minute two sessions a week, but not until the 26th postoperative week. The patients were seen for follow-up examinations four times during the first postoperative year (after 7, 13, 26 and 56 weeks). Shoulder function was assessed by the Constant Shoulder Score preoperatively and at the four follow-up examinations. Team instructed physiotherapy was found to improve the shoulder function significantly in patients treated surgically for breast cancer. The effect of the treatment was influenced by the type of surgery performed, and in mastectomised patients, also by the application of radiation therapy. Compromised shoulder function is a less frequent and less severe side effect to breast conserving therapy as compared to modified radical mastectomy.

Sentinel lymph node biopsy in breast cancer--experience with the combined use of dye and radioactive tracer at Aarhus University Hospital.

One hundred and twenty-four patients with palpable tumours underwent sentinel lymph node biopsy (SLNB) and subsequent axillary lymph node dissection. Ultrasound of the axilla was used as part of the diagnostic work-up on all patients and those with lymph node metastasis verified by fine-needle aspiration biopsy (FNAB) were not included. For identifying the SLNs, a combination of Tc-99m-labelled human albumin (Solco-ALBU-RES) and blue dye (Patent Blue V) was used. No lymphoscintigraphy was performed. The SLN was successfully identified in 122 out of 124 (98%) patients and 66 (54%) patients were found to have metastatic involvement of the axillary lymph nodes. In 52 (79%) of these patients, the SLNs were the only nodes involved, 28 (54%) had micrometastasis only. The false-negative rate was 1.5%. This method has proven valid in the staging of the axilla in patients with breast cancer. The advanced techniques of serial sectioning and immunohistochemical staining further improve the diagnostic advantage offered by the SLNB, as it increases the possibility of diagnosing micrometastatic deposits.