Meigs syndrome and gliomatosis peritonei: A case report and review of literature

Khan, Jehanzeb; McClennan, Bruce L.; Qureshi, Saadia; Martell, Maritza; Iyer, Anita; Bokhari, S. Jamal

doi:10.1016/j.ygyno.2005.03.048

Cited by 25 publications

(17 citation statements)

References 32 publications

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“…Typical symptoms of the disease are similar to those experienced in the present two cases, and affected patients may occasionally develop Pseudo-Meigs' syndrome associated with ascites and pleural effusions owing to ovarian teratoma (6). The pre-operative diagnosis of teratoma may be confirmed through the combination of imaging and clinical findings.…”

Section: Discussionsupporting

confidence: 76%

Gliomatosis peritonei with bilateral ovarian teratomas: A report of two cases

Wang

Zhang

et al. 2016

Oncology Letters

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Abstract. Gliomatosis peritonei (GP) is characterized by the presence of benign, mature neuroglial implants throughout the peritoneum and is typically accompanied by mature or immature ovarian teratomas. GP is a condition that has only been described relatively recently, with ~100 cases reported in the English literature. The majority of reported cases have focused on the pathology and clinical treatment of the disease; radiological findings are distinct, but the discussion of this is scarce in the literature. The current study presents two cases of GP with bilateral ovarian teratomas and provides a review of the relevant literature, with particular emphasis on the radiological differential diagnosis. The present study reinforces previously reported observations from imaging analysis and suggests that radiological investigation alone cannot sufficiently aid the differentiation of benign glial deposits from diffuse peritoneal malignant seeding. However, radiologists should be familiar with this rare condition in order to provide an accurate diagnosis, particularly in ovarian tumor staging, which may markedly impact the administered treatment. It is recommended that doctors undertake long-term follow-ups in patients presenting with GP due to the potential for malignant transformation. IntroductionGliomatosis peritonei (GP) is a rare condition that is typically associated with immature and, less commonly, mature teratomas and ventriculoperitoneal shunting. GP occurs commonly in young girls and, in rare cases, can be found in males. GP is characterized as a myriad of peritoneal nodular or miliary implants composed of benign, mature glia (1). As GP has an extremely low incidence rate, there is no widely accepted guidance as to the method by which these patients should be treated. Approximately 100 cases of GP have been described in the literature. Since the disease was first described by Neuhaüser in 1906 (2), it has been well-documented that GP, when benign, does not adversely affect patient prognosis. Glial implants associated with the disease may remain stable for long periods of time, or may completely disappear. The repeated measurement of tumor markers and imaging are usually undertaken throughout follow-up. To the best of our knowledge, only a few cases have been reported that describe the findings of a radiological analysis (3-5). The current study presents two cases of GP with bilateral ovarian teratomas, describing the diagnosis, associated radiological observations and complete clinical course of each patient. Case reportCase 1. A 19-year-old woman was referred to The Second Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China) on January 16, 2011, presenting with a 15-day history of lower abdominal distension. During a physical examination of the pelvis and abdomen, a large firm mass was identified and was palpable extending up to 20 cm to the xiphoid process. Analysis of serum tumor markers demonstrated an increase in carcinoembryonic antigen (13.4 ng/ml; normal range, <5 ng/ml), ...

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Section: Discussionsupporting

confidence: 76%

Gliomatosis peritonei with bilateral ovarian teratomas: A report of two cases

Wang

Zhang

et al. 2016

Oncology Letters

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“…About 100 cases have been retrieved in the literature. To our best knowledge, nine cases of nodal gliomatosis (including the present case) were demonstrated in the pelvic or paraaortic lymph nodes;1-8 eight cases were associated with both GP and ovarian teratomatous tumors, while the remaining case was without GP 6. Another interesting phenomenon is the rare combination of GP and endometriosis, as was seen in the present case.…”

Section: Discussionsupporting

confidence: 68%

“…To date, approximately 100 cases have been described in the literature. Eight cases with glial tissue in the pelvic and paraaortic lymph nodes, i.e., nodal gliomatosis, have been reported either in association with GP or in its absence 1-8. GP may coexist with endometriosis 9-15.…”

mentioning

confidence: 99%

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review

et al. 2013

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Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

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“…We describe an additional case to the second reported in the literature with pseudo-Meigs ' syndrome caused by endodermal sinus tumour. Although the pathophysiology of these fl uid collections is poorly understood, several theories about formation of ascitic fl uid have been proposed: irritation of peritoneum from the tumour; obstruction of the lymphatics by the tumour; fl uid secretion by the tumour from increased permeability of neovasculature; secondary to torsion of the pedicle of the tumour itself; low serum proteins and release of toxins and infl ammatory products (Khan et al 2005;. Th e fl uid in the chest in these patients originates from the fl uid in the abdomen, as has been determined by injecting indian ink into the ascites, which appears in the pleural eff usions aft er about 3 h (Amant et al 2001).…”

Section: Discussionmentioning

confidence: 99%