Magnetic resonance imaging findings in pseudo-Meigs' syndrome associated with a large uterine leiomyoma: a case report

Abstract

IntroductionPseudo-Meigs' syndrome is a rare pathological entity characterized by the presence of a pelvic mass other than an ovarian fibroma. The mass is associated with ascites with or without hydrothorax.Case presentationWe describe the case of a 41-year-old Caucasian woman with a large uterine leiomyoma associated with massive ascites. A magnetic resonance imaging scan showed a large subserosal leiomyoma with multiple areas of cystic degeneration.ConclusionTo the best of our knowledge, this is the first reported case of pseudo-Meigs' syndrome caused by a uterine leiomyoma and diagnosed using magnetic resonance imaging. The pathophysiology of this syndrome and the role of magnetic resonance imaging are emphasized in this case report.

Pseudo-Meigs’ syndrome associated with struma ovarii

“…Pseudo-Meigs’ syndrome is often characterised by pleural effusion and/or ascites caused by a pelvic tumour other than an ovarian fibroma. Reported ovarian tumours responsible for pseudo-Meigs’ syndrome are struma ovarii tumours, mucinous or serous cystadenomas, germ cell tumours and ovarian metastasis from colon and stomach cancers 2. If an ovarian solid mass is seen to be similar to thyroid tissue as both hyperechoic on ultrasound and hyperdense on unenhanced CT, struma ovarii should be considered in the differential diagnosis.…”

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

“…This syndrome is an important consideration in the differential diagnosis of ovarian cancer, and rarely causes fatal manifestations . Only 32 studies on pseudo‐Meigs' syndrome complicated with uterine leiomyoma have been reported using a medline search (search terms: pseudo‐Meigs' and leiomyoma, leiomyoma and ascites) since 1900 (Table ) . The association of uterine leiomyoma with ascites and/or PE was first reviewed by Kelly and Cullen in 1909 .…”

Massive Ascites in Pregnancy: Meigs' Syndrome

“…4 Pseudo-Meigs̓ syndrome is a clinically similar rare entity, except that it is characterised by the presence of other pelvic masses. 4,5 To the authors' knowledge, co-existing Meigs̓ syndrome and pregnancy is infrequent, and not many reports have been published. Foster 6 reported this association in the literature in 1971 in a pregnant woman of about 18 weeks of gestation who had a 2-cm left ovarian fibroma, ascites, and left pleural effusion.…”

“…As ovarian fibroma has a large fibrous component, it can have MRI signal intensities similar to those of a pedunculated fibroid. 5 Typically, fibroids demonstrate very low signal intensity on T2-weighted MRI, and high signal intensity on T2-weighted MRI for cystic degeneration. 2,8 Ovarian fibromas characteristically show low signal intensity on T2-weighted MRI, and intermediate-to-low signal intensity on T1-weighted MRI.…”

“…3 Cystic degeneration can be seen in both ovarian fibroma and uterine fibroid, and would appear as scattered high signal intensity areas on T2-weighted MRI. 2,5 The ability of MRI to depict the normal ovaries, even in the presence of a gravid uterus, would help to determine origin of the pelvic mass. Absence of a normal ipsilateral ovary helps distinguish fibromas from a pedunculated fibroid, as in this patient.…”