Discussion :
The dermoid cyst is a very common ovarian tumor (approximately 25% of
ovarian tumors) [1]. It occurs mainly in women during period of
genital activity [2].
In half of the cases, it is asymptomatic [2-5]. It can be discovered
as a result of pelvic pain, menstrual irregularities or complications
[2,5].
Diagnosis is based on imaging data, particularly ultrasound and CT,
which highlight the presence of heterogeneous calcium and fatty
components [6].
The complications of these ovarian cysts are dominated by torsion
(15%), rupture (1.3%), infection (1 to 2%) and more rarely
haemorrhage [2].
Rupture in the peritoneum is complicated by chemical peritonitis
[2,8,9]. The treatment of ruptured dermoid cysts of the ovary is
surgical, either by laparotomy or by laparoscopy.
Cystectomy is the standard procedure in young women, while oophorectomy
or adnexectomy is most often performed in postmenopausal women
[7,10].
Abundant washing of the peritoneal cavity should be performed with
saline solution and all visible particles of dermoid material (hair,
bone, fat and sebum) should be removed [10].
Examination of the anatomo-pathological specimen is essential and
mandatory in order to confirm the diagnosis and to look for an immature
dermoid component, in which case further surgery or chemotherapy should
be discussed.