Pseudo-Meigs Syndrome With Elevated CA 125 Levels

Domingo, Pere; Montiel, José; Monill, J M; Prat, Jaime

doi:10.1001/archinte.158.12.1378

Cited by 18 publications

(11 citation statements)

References 9 publications

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“…It is important to note that exertional dyspnea and wheeze, the chief complaint of the present patient, were also described in other similar cases [4,5] as initial symptoms. Since those symptoms are quite common in medical practice, it is important for clinicians to consider Meigs or pseudo-Meigs's syndrome when seeing patients who present bilateral pleural effusion without underlying conditions such as cardiac failure.…”

Section: Discussionsupporting

confidence: 79%

“…In addition to a single pathology, multiple concurrent intrapelvic tumors have also been described as a cause of pseudo-Meigs' syndrome [5]. Although the present patient had uteral leiomyoma, a reported cause for pseudo-Meigs' syndrome [4], ovarian cancer is likely to have been the causative pathology, since the leiomyoma had been followed up annually for years without significant change.…”

Section: Discussionmentioning

confidence: 61%

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Pseudo-Meigs’Syndrome as a Cause of Exertional Dyspnea: A Case Report

Ehara¹,

Koga

You

et al. 2009

Kurume Med. J.

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INTRODUCTIONIt is not rare to see patients with bilateral pleural effusion in clinical practice, and it is not unusual for such patients to present with exertional dyspnea [1]. Although several cardiopulmonary diseases account for most cases of pleural effusion [2], it occurs in diverse conditions and diseases. Bilateral pleural effusion develops in several systemic conditions such as hypoalbuminemia and collagen vascular diseases, and even in conditions unrelated to the cardiopulmonary system, including ovarian diseases such as Meigs' syndrome [3], a rare condition characterized by ovarian fibroma complicated by ascites and pleural effusion. We describe herein a patient presenting with exertional dyspnea who was diagnosed with pseudoMeigs' syndrome accompanying ovarian cancer. CASE REPORTA 61-year-old woman sought medical attention because of exertional dyspnea and an occasional wheeze that had developed one month previously without a noticeable triggering episode. She never smoked, consumed alcohol or took any medications. She underwent appendectomy at the age of nineteen, and was diagnosed when she was fifty as having myoma uteri, which was in stable condition on periodic check-ups. Her mother and a brother had diabetes, and another brother died of gastric cancer. Vital signs on presentation were as follows; blood pressure, 146/96 mmHg; pulse rate, 94 per minute with a regular rhythm; body temperature, 36.7°C; and respiration rate, 22 per minutes. She was neither anemic nor icteric. Finger clubbing was not noted. Neither lymphadenopathy nor venous dilation was noted on the neck. Thoracic examinations revealed diminished breath sound and dullness on percussion bilaterally. No wheeze was audible on this occasion. Heart sounds were not particular. Abdomen was flat, and there were no tender areas or masses on palpation. Neurological status was normal. Routine laboratory values were within the normal Kurume Medical Journal, 56, 85-87, 2009 Summary: A 61-year-old otherwise healthy woman presented with gradually worsening exertional dyspnea. Routine examinations revealed bilateral pleural effusion with no other notable cardiopulmonary diseases. Systemic examinations showed ascites and a pelvic tumor, which turned out to be right ovarian endometrioid adenocarcinoma. Surgical removal and chemotherapy against the ovarian cancer resulted in disappearance of the ascites and pleural effusion, establishing a diagnosis of pseudo-Meigs' syndrome. It is common for reported cases of pseudoMeigs' syndrome to initially present with dyspnea, therefore it is important to consider this disorder when attempting a differential diagnosis in female patients presenting with dyspnea without other noticeable conditions.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 61%

Pseudo-Meigs’Syndrome as a Cause of Exertional Dyspnea: A Case Report

Ehara¹,

Koga

You

et al. 2009

Kurume Med. J.

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“…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 .…”

Section: Discussionmentioning

confidence: 99%

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

Yonehara

Yanazume

Kitajima

et al. 2014

J of Obstet and Gynaecol

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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.

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“…1 By contrast, pseudo-Meigs' syndrome refers to pleural effusion, ascites and a malignant tumor, an ovarian teratoma, or a uterine leiomyoma. 2, 3 Tjalma described the first case report 5 Ural et al described a patient presenting with a photosensitive rash, detectable dsDNA and massive ascites along with an elevated serum CA-125 level; she was diagnosed with PPMS secondary to SLE. 6 Bes and Soy also described a case of a patient with lupus manifested by hydrothorax, ascites and elevated serum CA-125, but it is unclear to what degree leflunomide therapy contributed to her symptom complex.…”

Section: Discussionmentioning

confidence: 99%

Pseudo-pseudo Meigs’ syndrome in a patient with systemic lupus erythematosus

Dalvi

Yıldırım

Santoriello

et al. 2012

Lupus

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Pseudo-pseudo Meigs' syndrome (PPMS) is a rare manifestation of patients with systemic lupus erythematosus (SLE), defined by the presence of ascites, pleural effusions and an elevated CA-125 level. We describe a patient with longstanding lupus who presented with localized lymphadenopathy and subsequently developed massive chylous ascites with marked hypoalbuminemia. A brief historical overview of Meigs' syndrome and related entities is presented, along with a discussion of the differential diagnosis of hypoalbuminemia and ascites in an SLE patient. In addition, we speculate on the optimal therapeutic intervention in such a patient.

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Pseudo-Meigs Syndrome With Elevated CA 125 Levels

Cited by 18 publications

References 9 publications

Pseudo-Meigs’Syndrome as a Cause of Exertional Dyspnea: A Case Report

Pseudo-Meigs’Syndrome as a Cause of Exertional Dyspnea: A Case Report

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

Pseudo-pseudo Meigs’ syndrome in a patient with systemic lupus erythematosus

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