No abstract

BackgroundOvarian cancer (OC) is the most lethal gynecological malignancy with an overall 5-year survival of 45% [1]. Presence of pleural effusion, ascites, adnexal mass, and high levels of pretreatment CA125 are very suggestive of malignant ovarian tumor. Malignant pleural effusion must be confirmed as it is associated with worse prognosis and can influence the decision of primary treatment. Classic Meigs' syndrome (MS) was first described in 1937 by Meigs JW and Cass JW and consists of a benign solid ovarian fibroma with ascites and hydrothorax [2]. Both ascites and pleural effusion resolve after tumor removal. The prevalence of the syndrome is low but has important clinical implication as it mimics advanced malignant ovarian tumor presentation. In recent times other syndromes have emerged related to classic MS, namely malignant pseudo-Meigs'(Pseudo MS) which is referred to patients with pleural effusion, ascites and other benign or even malignant pelvic or abdominal tumors that lack evidence of peritoneal or pleural spread of the tumor (negative pleural and peritoneal fluid cytology and/or no malignant involvement in biopsy samples [3,4].Although they are well-recognized syndromes, their etiology is not well defined and there are contradictory data regarding their