Two Patients With Meigs' Syndrome and Elevated Serum CA-125: A Case Report

Navarro-Esteva, Javier; Laseca, Maria; Arencibia-Sánchez, Octavio

doi:10.7759/cureus.8927

Cited by 3 publications

(2 citation statements)

References 9 publications

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“… 1 Meigs’ syndrome stands in contrast to pseudo-Meigs’ syndrome, which also presents similar clinical symptoms but with ascites, pleural effusion, and ovarian or primary pelvic tumors other than fibromas, such as teratomas, struma ovarii, and leiomyomas. 8 , 9 However, in Meigs’ syndrome, ascites and pleural effusion should resolve after tumor removal.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Meigs’ Syndrome Caused by Ovarian Fibrothecoma with High Levels of CA125

Yuan,

Cui,

Wang

et al. 2024

IJWH

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Purpose Meigs’ syndrome is a rare gynecological disease characterized by the triad of benign ovarian tumor, ascites, and pleural effusion. Ovarian malignancies should be highly suspected in a postmenopausal woman with a pelvic mass, ascites, hydrothorax, and an elevated carbohydrate antigen 125 (CA125) level. It can be challenging to make a preoperative diagnosis of Meigs’ syndrome. In this report, we present a case of Meigs’ syndrome caused by an ovarian fibrothecoma and review the relevant literature to raise awareness and avoid misdiagnosis. Case Presentation An 82-year-old woman with a 2-week history of abdominal distension was admitted to the Department of Gynecology. Ultrasound and thoracoabdominal computed tomography scans showed a left-sided hypoechoic mass in the pelvic cavity with bilateral pleural effusion and massive ascites. The CA125 concentration was 1040 U/mL (normal, 0–35 U/mL). With a working diagnosis of ovarian malignancy, the patient underwent ultrasound-guided fine-needle puncture of the pelvic mass and paracentesis to drain the ascites. The fine-needle puncture and paracentesis fluid analysis results revealed that the ascites did not contain any tumor cells, and the pelvic mass was identified as a spindle cell tumor. Immunohistochemistry confirmed that it was a sex-cord stromal tumor. Total abdominal hysterectomy and bilateral adnexectomy were performed under general anesthesia. The pathology results confirmed the mass to have been an ovarian fibrothecoma. At the 2-month postoperative follow-up, the ascites and hydrothorax had resolved and not recurred, and the CA125 level was normal. Conclusion Despite the high suspicion of ovarian carcinoma in postmenopausal women presenting with pelvic mass, ascites, pleural effusion, and elevated CA125, Meigs’ syndrome should be considered.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Meigs’ Syndrome Caused by Ovarian Fibrothecoma with High Levels of CA125

Yuan,

Cui,

Wang

et al. 2024

IJWH

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“…Meigs syndrome presenting with an elevated CA125 is a rare clinical entity [17][18][19][20][21][22][23][24]. This condition mimics an ovarian malignancy, but Meigs syndrome should be considered in the differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Meigs Syndrome with Highly Elevated CA125

Imai

2022

BJSTR

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Meigs syndrome is an unusual condition consisting of benign solid ovarian tumors accompanied by ascites and/or pleural effusion. Usually Meigs syndrome does not result in serum CA125 elevation. The elevated CA125 level (>1000 U/ml) occurs more frequently in those with larger size tumor (>10cm) of Meigs syndrome. It has a clinical picture closely resembled to malignant ovarian cancer. Because diagnosis can only be made after pathological examination, surgery is an excellent tool for treatment with subsequent resolution of the ascites and hydrothorax.

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