Concentrated ascites re‐infusion therapy for pseudo‐Meigs' syndrome complicated by massive ascites in large pedunculated uterine leiomyoma

Abstract

Pseudo-Meigs' syndrome accompanied by massive ascites in uterine leiomyoma is rare. We encountered a rare case of a 37-year-old, nulliparous woman with a lower abdominal tumor and severe abdominal distention due to massive ascites. Serum cancer antigen 125 and vascular endothelial growth factor levels were elevated to 1007.9 U/mL and 103 pg/mL, respectively. She was tentatively diagnosed with ovarian cancer. Emergency concentrated ascites re-infusion therapy was performed to improve dyspnea, abdominal pain, and her preoperative respiratory condition. Concentrated ascites re-infusion therapy eliminated dyspnea and abdominal discomfort without decreasing serum albumin levels. The patient underwent laparotomy, which revealed a fist-sized pedunculated uterine leiomyoma arising from the right uterine fundus. Myomectomy was performed. Pseudo-Meigs' syndrome mimics advanced ovarian cancer due to massive ascites and markedly elevated serum cancer antigen 125 and vascular endothelial growth factor levels. Concentrated ascites re-infusion therapy was effective in improving the subjective symptoms of pseudo-Meigs' syndrome and the patient's preoperative condition.

Comparison of clinical outcomes and postoperative quality of life after surgical treatment of type II submucous myoma via laparoscopy or hysteroscopy

“…However, it has some limitations in the treatment of large submucous myomas, such as the risk of uterine perforation, increased bleeding, and incomplete excision. 17,18 The main complications include intraoperative bleeding, uterine perforation, gynaecological transurethral resection syndrome (similar to transurethral resection of the prostate syndrome), and air embolism. 19 Complete TCRM could not be achieved at one time in six patients in the present study because of the large tumour size and intraoperative liquid absorption.…”