Meigs Syndrome: Case Report
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n2.3939Keywords:
Meigs syndrome, fibroma, ascites, pleural effusion, surgical oncologyAbstract
Introduction: Meigs syndrome is a rare clinical condition, defined as the association of pleural effusion, ascites and ovarian fibroma, with resolution of symptoms after tumor resection. Case report: Female patient, 56 years old, with dry cough associated with hyporexia, weight loss and progressive dyspnea for one month. Chest X-ray and later chest tomography showed massive pleural effusion on the right. Thoracocentesis was performed with drainage of 2,500 ml of serous fluid, suggestive of exudate. On examination, a palpable mass was observed in the hypogastrium, with an upper limit in the umbilicus. Imaging exams show solid expansive formation of possible left ovarian origin and presence of ascitic fluid. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy and resection of the pelvic mass. Intraoperatively, frozen section was suggestive of ovarian fibroma. Histopathological of the surgical specimen confirmed ovarian fibroma measuring 13.0 x 12.5 x 7.5 cm and cytopathological examination of the ascitic fluid was negative for neoplastic cells. The patient evolved in good general condition with resolution of the pleural effusion and ascites and continues without recurrence of symptoms. Conclusion: The definitive diagnosis is made by histological confirmation of ovarian fibroma and resolution of symptoms after removal of the tumor. Dyspnea may be the initial symptom and the CA-125 may be elevated. The prognosis is usually good and the chances of recurrence are minimal.
Downloads
References
Nguyen P, Yazdanpanah O, Schumaker B. Meigs' versus pseudo-Meigs' syndrome: a case of pleural effusion, ascites, and ovarian mass. Cureus. 2020;12(8):e9704. doi: https://doi.org/10.7759/cureus.9704 DOI: https://doi.org/10.7759/cureus.9704
Tsukao H, Ueda T, Fujii Y, et al. Incomplete pseudo-Meigs' syndrome caused by endometrial ovarian cyst: a case report. Respir Med Case Rep. 2021;33:101387. doi: https://doi.org/10.1016/j.rmcr.2021.101387 DOI: https://doi.org/10.1016/j.rmcr.2021.101387
Hou YY, Peng L, Zhou M. Meigs syndrome with pleural effusion as initial manifestation: a case report. World J Clin Cases. 2021;9(21):5972-9. doi: https://doi.org/10.12998/wjcc.v9.i21.5972 DOI: https://doi.org/10.12998/wjcc.v9.i21.5972
Saha S, Robertson M. Meigs' and pseudo-Meigs' syndrome. Australas J Ultrasound Med. 2012;15(1):29-31. doi: https://doi.org/10.1002/j.2205-0140.2012.tb00140.x DOI: https://doi.org/10.1002/j.2205-0140.2012.tb00140.x
Dalvi SR, Yildirim R, Santoriello D, et al. M. Pseudo-pseudo Meigs' syndrome in a patient with systemic lupus erythematosus. Lupus. 2012;21(13):1463-6. doi: https://doi.org/10.1177/09612033124612 DOI: https://doi.org/10.1177/0961203312461291
Krenke R, Maskey-Warzechowska M, Korczynski P, et al. Pleural effusion in Meigs' syndrome-transudate or exudate?: systematic review of the literature. Medicine (Baltimore). 2015;94(49):e2114. doi: https://doi.org/10.1097/MD.0000000000002114 DOI: https://doi.org/10.1097/MD.0000000000002114
Conselho Nacional de Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção 1:59.
Tan N, Jin KY, Yang XR, et al. A case of death of patient with ovarian fibroma combined with Meigs syndrome and literature review. Diagn Pathol. 2022;17(1):83. doi: https://doi.org/10.1186/s13000-022-01258-9 DOI: https://doi.org/10.1186/s13000-022-01258-9
Javadi S, Ganeshan DM, Jensen CT, et al. Comprehensive review of imaging features of sex cord-stromal tumors of the ovary. Abdom Radiol (NY). 2021;46(4):1519-29. doi: https://doi.org/10.1007/s00261-021-02998-w DOI: https://doi.org/10.1007/s00261-021-02998-w
Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting Meigs syndrome. J Bronchology Interv Pulmonol. 2013;20(1):48-51. doi: https://doi.org/10.1097/LBR.0b013e31827ccb35 DOI: https://doi.org/10.1097/LBR.0b013e31827ccb35
Hatoum S, Jarjoura P, Saade C, et al. Sclerosing stromal tumor of the ovary presenting as Meigs syndrome during childhood. Cureus. 2022;14(11):e31562. doi: https://doi.org/10.7759/cureus.31562 DOI: https://doi.org/10.7759/cureus.31562
Fremed MA, Levin TL, Sun KY, et al. Ovary preservation in the treatment of childhood Meigs syndrome. Pediatri Blood Cancer. 2015;62(11):2011-4. doi: https://doi.org/10.1002/pbc.25586 DOI: https://doi.org/10.1002/pbc.25586
Published
How to Cite
Issue
Section
License
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.

This work is licensed under a Creative Commons Attribution 4.0 International License.