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Reumatologia Clinica 2019Tjalma syndrome or pseudo-pseudo Meigs' syndrome is a clinical condition characterized by pleural effusion, ascites and elevated CA-125 with no associated benign or... (Review)
Review
Tjalma syndrome or pseudo-pseudo Meigs' syndrome is a clinical condition characterized by pleural effusion, ascites and elevated CA-125 with no associated benign or malignant ovarian tumor in a patient with systemic lupus erythematosus (SLE). Tjalma described the first case of a patient with SLE, pleural effusion, ascites and elevated CA-125. We report the first case in a 14-year old patient who presented with ascites and pleural effusion refractory to treatment and elevated CA-125, in the absence of an ovarian tumor, that warranted aggressive management.
Topics: Acute Kidney Injury; Adolescent; Ascites; CA-125 Antigen; Cyclophosphamide; Female; Humans; Lupus Erythematosus, Systemic; Meigs Syndrome; Paracentesis; Pleural Effusion; Purpura, Thrombotic Thrombocytopenic; Rituximab
PubMed: 28522234
DOI: 10.1016/j.reuma.2017.04.003 -
Taiwanese Journal of Obstetrics &... Nov 2021Adult-type granulosa cell tumors (GCT) are sex cord-stromal tumors and often accompanied with abdominal distention and hyperestrogenism-related symptoms. Adult-type...
OBJECTIVE
Adult-type granulosa cell tumors (GCT) are sex cord-stromal tumors and often accompanied with abdominal distention and hyperestrogenism-related symptoms. Adult-type GCT-presenting ascites and pleural effusion is extremely rare.
CASE REPORT
A 56-year-old perimenopausal woman presented with abdominal distention and abnormal vaginal spotting. Ultrasound and abdominal computed tomography showed a complex cystic mass in the left ovary accompanied with bilateral pleural effusion and ascites. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, left pelvic lymph node dissection, omentectomy and appendectomy. Final histopathological diagnosis was adult-type GCT. The patient had postoperative hormone and anti-angiogenesis agent therapy with free of disease.
CONCLUSION
Ovarian cystic complex mass accompanied with ascites and pleural effusion often results from malignant ovarian tumors or benign ovarian fibroma. Based on the aforementioned report, the rare types of ovarian tumors, such as adult-type granulosa cell tumor of the ovary should be taken into consideration.
Topics: Antineoplastic Agents, Hormonal; Ascites; Bevacizumab; Cytoreduction Surgical Procedures; Female; Gonadotropin-Releasing Hormone; Goserelin; Granulosa Cell Tumor; Humans; Laparotomy; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Ovary; Pleural Effusion; Salpingo-oophorectomy; Treatment Outcome
PubMed: 34794749
DOI: 10.1016/j.tjog.2021.09.028 -
The American Journal of Emergency... Jul 1998Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' is a variant not possessing the...
Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. This case concerns a 21-year-old woman who presented to the emergency department (ED) with a recurrent hydrothorax. After performing a pelvic examination that was suspicious for a pelvic mass, further evaluation by ultrasonography showed ascites and a pelvic tumor. Surgeons from the Obstetrics and Gynecology Department performed an exploratory laparotomy with removal of the tumor. Subsequently, there was no recurrence of the ascites and hydrothorax. The tumor was diagnosed histologically as a benign mature teratoma. The literature of Meigs' and Pseudo-Meigs' is reviewed, focusing on the history, pathology, and clinical characteristics. The clinical significance for the emergency physician is discussed.
Topics: Adult; Ascites; Diagnosis, Differential; Emergency Treatment; Female; Humans; Hydrothorax; Meigs Syndrome; Recurrence; Teratoma
PubMed: 9672464
DOI: 10.1016/s0735-6757(98)90141-3 -
The Journal of the Kansas Medical... Sep 1976
Topics: Female; Humans; Meigs Syndrome; Middle Aged
PubMed: 965797
DOI: No ID Found -
British Medical Journal Oct 1954
Topics: Female; Humans; Meigs Syndrome; Neoplasms; Ovarian Neoplasms; Ovary
PubMed: 13199315
DOI: No ID Found -
British Medical Journal Mar 1958
Topics: Female; Humans; Meigs Syndrome; Neoplasms; Ovarian Neoplasms; Ovary
PubMed: 13510752
DOI: 10.1136/bmj.1.5071.628 -
Modern Rheumatology Case Reports Jul 2021Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal... (Review)
Review
Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal pseudo-obstruction, and pancreatitis. We describe a 23-year-old female, a known case of SLE presented with significant ascites and pleural effusion. Further evaluation showed elevated CA-125 levels without evidence of malignancy. The patient was treated with corticosteroids, hydroxychloroquine, and azathioprine resulting in the resolution of ascites in 2 weeks. The triad of ascites, pleural effusion, and increased CA-125 is known as pseudo-pseudo Meigs' syndrome, which is rarely reported in the literature. Clinicians should be aware of this entity while evaluating an SLE patient with low serum-ascites albumin gradient (SAAG) ascites.
Topics: Chronic Disease; Female; Humans; Lupus Erythematosus, Systemic; Meigs Syndrome; Young Adult
PubMed: 33970813
DOI: 10.1080/24725625.2021.1916160 -
Journal of Thoracic Imaging Apr 2003The association of a benign ovarian tumor with ascites and hydrothorax that resolve after tumor resection is known as Meigs syndrome, and its importance was first...
The association of a benign ovarian tumor with ascites and hydrothorax that resolve after tumor resection is known as Meigs syndrome, and its importance was first emphasized by Meigs and Cass in 1937. The importance of Meigs syndrome is that the presence of ascites and pleural effusion does not necessarily indicate that a pelvic mass is malignant. The benign tumors in Meigs syndrome are usually fibromas or fibrothecomas and constitute 4% of all ovarian neoplasms. The authors present a case of Meigs syndrome with an ovarian fibroma. They focus on the evaluation of pleural fluid in the setting of an ovarian mass and then briefly discuss the imaging of ovarian fibromas and fibrothecomas.
Topics: Diagnosis, Differential; Female; Fibroma; Humans; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Tomography, X-Ray Computed
PubMed: 12700485
DOI: 10.1097/00005382-200304000-00009 -
BMJ Case Reports Mar 2021A 64-year-old woman referred to Gynaecological Oncology secondary to the finding of pelvic mass and ascites. Imaging showed multiple pelvic masses, with the largest mass...
A 64-year-old woman referred to Gynaecological Oncology secondary to the finding of pelvic mass and ascites. Imaging showed multiple pelvic masses, with the largest mass measuring 20 cm in diameter, as well as bilateral pleural effusions and abdominal ascites, suspicious for ovarian carcinoma. Laboratory findings included elevated cancer antigen 125 (CA-125) of 2124 units/mL. The patient underwent an exploratory laparotomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy for pathological evaluation. Postoperatively, the patient had resolution of ascites and pleural effusion. Surgical pathology revealed a 26 cm right ovarian fibroma, confirming the diagnosis of Meigs syndrome. Despite the high suspicion for ovarian carcinoma in patients presenting with elevated CA-125 level, pelvic mass, ascites and pleural effusion, the diagnosis of Meigs syndrome cannot be excluded without pathological evaluation of mass.
Topics: Ascites; CA-125 Antigen; Female; Humans; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Pleural Effusion; Salpingo-oophorectomy
PubMed: 33653838
DOI: 10.1136/bcr-2020-238931 -
BMC Cardiovascular Disorders Oct 2020Meigs' syndrome is a rare disease characterized by a triad of presentations, including benign ovarian tumor, ascites, and pleural effusion. However, a clinical diagnosis...
BACKGROUND
Meigs' syndrome is a rare disease characterized by a triad of presentations, including benign ovarian tumor, ascites, and pleural effusion. However, a clinical diagnosis of Meigs' syndrome remains challenging because pleural and ascitic effusions can be common findings in a variety of underlying conditions. Furthermore, these findings can often be misdiagnosed as pleural and peritoneal dissemination caused by potentially malignant tumors, leading to the administration of improper treatment.
CASE PRESENTATION
We described a case of an 85-year-old postmenopausal female patient with atypical Meigs' syndrome presenting with right-sided pleural effusion, notable leg edema, and trivial ascites, which was initially mistaken as heart failure with preserved ejection fraction. However, pleural effusion was totally ineffective against diuretic therapy. Subsequently, thoracentesis yielded serosanguineous exudative effusion. Moreover, refractory pleural effusions and abdominal/pelvic computed tomography and magnetic resonance imaging findings strongly suggested bilateral malignant ovarian tumors with pleural dissemination. Repetitive negative cytological results allowed the patient to undergo bilateral salpingo-oophorectomy. Finally, a definitive diagnosis of Meigs' syndrome was made by confirming the presence of a benign mitotically active cellular fibroma of the ovary by pathology and that pleural effusion resolved following tumor resection.
CONCLUSIONS
Our case highlights the clinical importance of assessing Meigs' syndrome in the diagnostic workup of pleural effusion in postmenopausal female patients. Given the favorable prognosis of Meigs' syndrome, clinicians should consider surgical resection, even with potentially malignant ovarian tumors with accompanying pleural effusion, ascites, or both.
Topics: Aged, 80 and over; Diagnosis, Differential; Diagnostic Errors; Female; Heart Failure; Humans; Meigs Syndrome; Predictive Value of Tests; Salpingo-oophorectomy; Stroke Volume; Treatment Outcome; Ventricular Function, Left
PubMed: 33028203
DOI: 10.1186/s12872-020-01718-4