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Surgical Case Reports Dec 2016We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A...
We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A 57-year-old female visited a hospital for a 2-month history of abdominal distension and voiding difficulty. Massive pleural effusion on the right side and a small amount of left-sided pleural effusion were detected on CT. She underwent emergent laparotomy due to the severe symptom of abdominal distention. The tumor originated from the left ovary, and left-sided oophorectomy was performed.The histologic finding was moderately differentiated adenocarcinoma suggesting metastatic carcinoma from the colon. Left thoracic effusion disappeared at 3 days after the removal of the ovarian tumor. Subsequently, colon carcinoma of the cecum was detected by colonoscopy. The patient underwent second laparotomy of right colectomy and lymph node dissection. However, 6 months after the operation, pleural effusion on the right side re-developed again, and the serum levels of CEA and CA125 were elevated at 105 ng/ml and 125 U/ml, respectively. CT again revealed a large ovarian tumor. She subsequently underwent third laparotomy of right-sided oophorectomy and hysterectomy. Pleural effusion and ascites disappeared in a few days after the operation.The patient developed both synchronous and metachronous ovarian metastases and achieved a 7-year disease-free survival after the operation. The pathogenesis of pseudo-Meigs' syndrome should be distinguished from carcinomatous peritonitis and/or pleuritis of malignant disease.
PubMed: 27734419
DOI: 10.1186/s40792-016-0209-7 -
Journal of Neuroimmune Pharmacology :... Sep 2020Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2, is a positive-sense... (Review)
Review
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2, is a positive-sense single-stranded RNA virus with epithelial cell and respiratory system proclivity. Like its predecessor, SARS-CoV, COVID-19 can lead to life-threatening disease. Due to wide geographic impact affecting an extremely high proportion of the world population it was defined by the World Health Organization as a global public health pandemic. The infection is known to readily spread from person-to-person. This occurs through liquid droplets by cough, sneeze, hand-to-mouth-to-eye contact and through contaminated hard surfaces. Close human proximity accelerates SARS-CoV-2 spread. COVID-19 is a systemic disease that can move beyond the lungs by blood-based dissemination to affect multiple organs. These organs include the kidney, liver, muscles, nervous system, and spleen. The primary cause of SARS-CoV-2 mortality is acute respiratory distress syndrome initiated by epithelial infection and alveolar macrophage activation in the lungs. The early cell-based portal for viral entry is through the angiotensin-converting enzyme 2 receptor. Viral origins are zoonotic with genomic linkages to the bat coronaviruses but without an identifiable intermediate animal reservoir. There are currently few therapeutic options, and while many are being tested, although none are effective in curtailing the death rates. There is no available vaccine yet. Intense global efforts have targeted research into a better understanding of the epidemiology, molecular biology, pharmacology, and pathobiology of SARS-CoV-2. These fields of study will provide the insights directed to curtailing this disease outbreak with intense international impact. Graphical Abstract.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32696264
DOI: 10.1007/s11481-020-09944-5 -
Journal of Surgical Case Reports Jun 2022Ascites, pelvic mass and elevated CA-125 in females carry a grim prognosis, likely an ovarian carcinoma. However, more benign etiologies such as Meigs' and pseudo-Meigs'...
Ascites, pelvic mass and elevated CA-125 in females carry a grim prognosis, likely an ovarian carcinoma. However, more benign etiologies such as Meigs' and pseudo-Meigs' syndrome must be considered. Pseudo-Meigs' syndrome presenting with an elevated CA-125 is rare and presents a diagnostic challenge. Medline and PubMed were queried for pseudo-Meigs' syndrome cases. We present a 35-year-old female patient who presented with abdominal swelling and weight gain. Imaging demonstrated a 29-cm large intraabdominal mass with significant ascites with elevation of CA-125. Surgical resection was performed, and pathology identified uterine leiomyoma. Twenty-one cases of pseudo-Meigs' syndrome were identified in the literature. Most patients presented with abdominal distention, and some also reported dyspnea. All patients, including our case, were treated surgically. No recurrence reported among these cases. Surgery is the mainstay for radical treatment in pseudo-Meigs' syndrome. Resolution of the ascites and hydrothorax occurs following resection of the tumor.
PubMed: 35685293
DOI: 10.1093/jscr/rjac253 -
Cureus Jun 2020Patients with Meigs' syndrome and elevated serum CA-125 are not frequently reported. A 59-year-old woman and a 48-year-old woman sought help because of progressive...
Patients with Meigs' syndrome and elevated serum CA-125 are not frequently reported. A 59-year-old woman and a 48-year-old woman sought help because of progressive shortness of breath caused by pleural effusion. The presence of a pelvic mass was noted in both the patients and was thought to be the cause of the effusion. Both patients had elevated serum CA-125, which raised the possibility of malignancy. After complete resection of the tumors, the pathologic reports confirmed a benign and a low-grade malignant ovarian neoplasia, respectively. We comment on the outcome and follow-up of these two cases and briefly review Meigs' syndrome.
PubMed: 32760627
DOI: 10.7759/cureus.8927 -
Frontiers in Oncology 2023Ovarian metastasis of breast cancer with pseudo-Meigs' syndrome (PMS) is extremely rare. Only four cases of PMS secondary to breast cancer with ovarian metastasis have...
Ovarian metastasis of breast cancer with pseudo-Meigs' syndrome (PMS) is extremely rare. Only four cases of PMS secondary to breast cancer with ovarian metastasis have been reported to date. In this report, we present the fifth case of PMS caused by ovarian metastasis of breast cancer. On the 2nd of July 2019, a 53-year-old woman presented to our hospital with complaints of abdominal distension, irregular vaginal bleeding, and chest distress. Color Doppler ultrasound examination revealed a mass approximately 109×89 mm in size in the right adnexal area, accompanied by multiple uterine fibroids and a large amount of pelvic and peritoneal effusions. The patient had no common symptoms and showed no signs of breast cancer. The main manifestations were a right ovarian mass, massive hydrothorax, and ascites. Lab workup and imaging revealed raised CA125 (cancer antigen 125) levels and multiple bone metastases. At first the patient was misdiagnosed with ovarian carcinoma. After the rapid disappearance of oophorectomy hydrothorax and ascites, and decreased CA125 levels, from 1,831.8u/ml to normal range. According to the pathology report, breast cancer was finally diagnosed. The patient underwent endocrine therapy (Fulvestrant) and azole treatment after oophorectomy. At the 40-month follow-up, the patient was still alive and doing well.
PubMed: 37223687
DOI: 10.3389/fonc.2023.1091956 -
World Journal of Clinical Cases Jul 2021Meigs syndrome is a rare neoplastic disease characterized by the triad of benign solid ovarian tumor, ascites, and pleural effusion. In postmenopausal women with pleural...
BACKGROUND
Meigs syndrome is a rare neoplastic disease characterized by the triad of benign solid ovarian tumor, ascites, and pleural effusion. In postmenopausal women with pleural effusions, ascites, elevated CA-125 level, and pelvic masses, the probability of disseminated disease is high. Nevertheless, the final diagnosis is based on its histopathologic features following surgical removal of a mass lesion. Here we describe a case of Meigs syndrome with pleural effusion as the initial manifestation.
CASE SUMMARY
A 52-year-old woman presented with a 2-mo history of dry cough and oppression in the chest and was admitted to our hospital due to recurrent pleural effusion and gradual worsening of dyspnea that had occurred over the previous month. Two months before admission, the patient underwent repeated chest drainage and empirical anti-tuberculosis treatment. However, the pleural fluid accumulation persisted, and the patient began to experience dyspnea on exertion leading to admission. A computed tomography scan of the chest, abdominal ultrasound, and magnetic resonance imaging confirmed the presence of right-sided pleural effusion and ascites with a right ovarian mass. Serum tumor markers showed raised CA-125. With a suspicion of a malignant tumor, the patient underwent laparoscopic excision of the ovarian mass and the final pathology was consistent with an ovarian fibrothecoma. On the seventh day postoperation, the patient had resolution of the right-sided pleural effusion.
CONCLUSION
Despite the relatively high risk of malignancy when an ovarian mass associated with hydrothorax is found in a patient with elevated serum levels of CA-125, clinicians should be aware about rare benign syndromes, like Meigs, for which surgery remains the preferred treatment.
PubMed: 34368316
DOI: 10.12998/wjcc.v9.i21.5972 -
International Journal of Surgery Case... Sep 2023Herein, we describe a case of Meigs' syndrome, a complex condition that poses a challenge for anesthesiologists to manage. Good anesthetic management of this syndrome is...
INTRODUCTION
Herein, we describe a case of Meigs' syndrome, a complex condition that poses a challenge for anesthesiologists to manage. Good anesthetic management of this syndrome is necessary to preserve the prognosis.
PRESENTATION OF CASE
An 80-year-old woman was admitted to the emergency department with complaints of abdominal pain, particularly in the left lower abdomen, with aggravation after activity. The patient was unable to sleep in a supine position. Her serum carbohydrate antigen 125 level was 253.15 U/mL, and laboratory examinations were nonspecific. On auscultation, breath sounds were absent from the base of the right lung. Abdominal computed tomography (CT) was performed to screen for a possible tumor consisting of both solid and cystic components, but the findings were inconclusive. Chest CT showed large right pleural effusions and hiatal hernia.
DISCUSSION
A multidisciplinary team conducted careful preoperative preparation, while the anesthesiology team prepared detailed peri-anesthesia management strategies to regulate acid-base and electrolyte balance and maintain respiratory and hemodynamic stability. The surgeon resected the tumor successfully. The patient was discharged after 1 week. A postoperative pathology test confirmed fibrothecomas.
CONCLUSION
We provided an effective strategy for the anesthetic management of Meigs' syndrome, which remains a complex challenge for anesthesiologists. It is important that anesthesiologists perform adequate preoperative evaluation and prudent peri-anesthesia management to ensure that patients have a good prognosis and discharge healthily. A multidisciplinary team is essential when caring for patients with Meigs' syndrome.
PubMed: 37579630
DOI: 10.1016/j.ijscr.2023.108660 -
Respiratory Medicine Case Reports 2021A 63-year-old female was admitted to our hospital with history of persistent dyspnea. Right pleural effusion and ovarian tumor were discovered, but here were no...
A 63-year-old female was admitted to our hospital with history of persistent dyspnea. Right pleural effusion and ovarian tumor were discovered, but here were no significant findings on thoracoscopy under local anesthesia. The pleural effusion was suspected to be secondary to Meigs' syndrome, and a diagnosis of endometriotic ovarian cyst was made. Since the pleural effusion resolved after surgery, the patient was diagnosed with incomplete pseudo-Meigs' syndrome. We consider this to be a valuable case, as there are no previously reported cases of pseudo-Meigs' syndrome derived from an endometriotic ovarian cyst, to the best of our knowledge.
PubMed: 33854937
DOI: 10.1016/j.rmcr.2021.101387 -
Journal of Ovarian Research Feb 2018Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. Pseudo-Meigs' syndrome with ascites, pleural effusion, and elevated serum... (Review)
Review
Precise preoperative diagnosis of struma ovarii with pseudo-Meigs' syndrome mimicking ovarian cancer with the combination of I scintigraphy and F-FDG PET: case report and review of the literature.
BACKGROUND
Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. Pseudo-Meigs' syndrome with ascites, pleural effusion, and elevated serum CA 125 levels is much rarer and leads to misdiagnosis of ovarian cancer and unnecessary extended surgery.
CASE PRESENTATION
A 50-year-old woman with abdominal distention and dyspnoea was referred to our hospital. Ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed a polycystic ovarian tumor with a solid component, pleural effusion, and massive ascites with negative cytology. Her serum CA 125 level was 1237 U/ml, indicating the presence of ovarian cancer. Based on increased uptake of I but no uptake of F-FDG in the tumor, the preoperative diagnosis was struma ovarii with pseudo-Meigs' syndrome, which was confirmed histologically. She had no evidence of ascites and pleural effusion six months after surgery.
CONCLUSIONS
To date, there have been no systematic reviews focused on preoperative diagnosis with imaging modalities. The combination of I scintigraphy and F-FDG PET/CT in addition to conventional imaging modalities can provide the precise preoperative diagnosis of struma ovarii with pseudo-Meigs' syndrome mimicking ovarian cancer, leading to the appropriate treatment strategy.
Topics: Biopsy; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Histocytochemistry; Humans; Iodine Radioisotopes; Meigs Syndrome; Middle Aged; Multimodal Imaging; Ovarian Neoplasms; Positron Emission Tomography Computed Tomography; Preoperative Care; Radionuclide Imaging; Struma Ovarii
PubMed: 29391043
DOI: 10.1186/s13048-018-0383-2