Pseudomeigs is a variant not possessing the original tumor cell types described by meigs. Ascites, ca 125, gynecology, leiomyoma, pseudomeigs syndrome jake alan gibbons. The pathophysiology of pseudomeigs syndrome with elevated ca 125 forms the basis of this. A 20 year old hispanic female presents with worsening fatigue and total body swelling for 2 weeks.
Pseudomeigs syndrome is a rare neoplastic disease characterized by the presence of a benign or malignant, pelvic or abdominal tumor other than ovarian. Aggressive treatment, including r0 resection, for this disease if. We report a challenging case of pseudomeigs syndrome associated with ovarian mucinous carcinoma in a patient with recurrent rightsided exudative, eosinophilic pef. Meigs separated his definition into true meigs syndrome, which he preferred to call demonsmeigs syndrome and pseudomeigs syndrome distinguished by different tumor types. Pseudo meigs syndrome secondary to colorectal adenocarcinoma metastasis to the ovaries a 61yearold woman with history of left hemisphere meningi. Pathology entities that have been reported to result in pseudo meigs syndrome inclu. Pseudomeigs syndrome with elevated ca 125 levels cancer.
We present three cases of pseudomeigs syndrome secondary to ovarian metastasis from colorectal cancer. Pseudo pseudo meigs syndrome in a patient with systemic lupus erythematosus. Case report open access pseudomeigs syndrome due to ovarian metastases from colon cancer. Three cases of pseudomeigs syndrome secondary to ovarian.
In medicine, meigs syndrome, also meigs syndrome or demonsmeigs syndrome, is the triad of ascites, pleural effusion, and benign ovarian tumor ovarian fibroma, fibrothecoma, brenner tumour, and occasionally granulosa cell tumour. Longterm survival in pseudomeigs syndrome caused by. We report the case of puerperal ascites, associated with elevated ca125 levels and secondary to a uterine myoma. Meigs syndrome and pseudo meigs syndrome both presents with hydrothorax and ascites. Mar 24, 2016 meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor. Pdf pseudomeigs syndrome with degenerative uterine. When ascites and pleural effusion are present, the possibility of metastatic disease will always be considered. Treatment was initiated with prednisone, mycophenolate mofetil. To our knowl edge this is the first case described through a medline search. Tjalma described the first case of a patient with sle, pleural effusion, ascites and elevated ca125. Pseudomeigs syndrome consists of pleural effusion an example of which can be seen in the image below, ascites, and benign tumors of the. Our experience suggests that pseudomeigs syndrome can occur in a patient. An unusual and rare case of broad ligament leiomyoma with massive ascites and bilateral pleural effusion is described. Pseudomeigs syndrome the american journal of emergency.
Ovarian fibromas constitute the majority of the benign tumors seen in meigs syndrome. Pseudomeigs syndrome in association with primitive. Pseudomeigs syndrome due to ovarian metastases from colon. It consists of pleural effusion, ascites, and elevated tumor marker ca125 in the absence of ovarian pathology. Pseudomeigs syndrome is the association of an ovarian tumor with benign ascites and hydrothorax. Meigs syndrome and pseudo meigs syndrome are a rare disorder. We report here a rare case of pseudomeigs syndrome caused by ovarian metastases from sigmoid colon cancer with longterm survival. Severe inflammation may be caused by hyperferritinemia of pseudo pseudo meigs syndrome in lupus patients.
Pseudomeigs syndrome due to highgrade serous ovarian carcinoma. A 48yearold perimenopausal woman presented with a long history of 810 years of abdominal distension. Get a printable copy pdf file of the complete article 408k, or click on a page image below to browse page by page. The ascites and pleural effusion resolved dramatically following removal of the tumor. The majority of cases usually resolve after surgical resection of the ovarian mass. Pseudomeigs syndrome is characterised by pleural effusion, ascites and benign ovarian tumours other than fibromas as described by meigs. Fibroma of the ovary with ascites and hydrothorax meigs syndrome. Meigs described the syndrome of ascites and hydrothorax accompanying benign ovarian tumours. When the genital tumor is a fibroma or a fibrothecoma or a granulosa cells tumor,and only in these cases,it is a demons meigs syndrome. Pseudomeigs syndrome is a clinical syndrome where pleural effusion pef andor ascites are associated with ovarian tumor other than fibroma. Links to pubmed are also available for selected references. Pseudomeigs syndrome associated with struma ovarii bmj.
In this study, we described four new cases of meigs syndrome and pseudomeigs syndrome to further characterize the clinical and pathological features of. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Full text is available as a scanned copy of the original print version. Pseudo meigs syndrome with degenerative uterine leiomyoma in pregnancy article pdf available in taiwanese journal of obstetrics and gynecology 433. Malignant pseudomeigs syndrome presenting as recurrent. Meigs syndrome secondary to broad ligament leiomyoma. Meigs syndrome associated with hydropic degenerating. Data of immunohistochemistry study were consistent with high grade serous carcinoma.
Meigs syndrome represents a triad of pleural effusion, ascites, and an ovarian tumor, which is usually benign, occurring together. It has been described mostly in patients without a known prior diagnosis of sle and often presents with painless, gradual onset, mild to moderate. Diagnostic challenges of the syndrome and the mechanisms of effusions are also commented. Pseudomeigs syndrome caused by a hydropic degenerating. Meigs syndrome presenting with axillary vein thrombosis and pseudo meigs secondary to colorectal adenocarcinoma meigs elevated ca 125 case report a. Pseudopseudo meigs syndrome ppms is a newly emerging. The etiology is not yet clear, but chronic peritonitis and pleuritis may be the underlying mechanism.
In 1937, meigs described a syndrome of ovarian fibromas with ascites and hydrothorax that quickly resolved on removal of the fibroma. Pseudo meigs is a variant not possessing the original tumor cell types described by meigs. Pseudopseudo meigs syndrome is a rare manifestation of sle, which is less recognized by clinicians. As a rule, resolution of ascites and pleural effusions occurs after removal of the ovarian lesion. It has been described mostly in patients without a known prior diagnosis of sle and often presents with painless, gradual onset, mild to moderate ascites.
Thecause ofascites andpleural effusion in both meigs syndrome and atypical meigs syndrome is obscure. Tjalma syndrome or pseudopseudo meigs syndrome is a clinical condition characterized by pleural effusion, ascites and elevated ca125 with no associated benign or malignant ovarian tumor in a patient with systemic lupus erythematosus sle. I n this study, we described four new cases of meigs syndrome and pseudo meigs syndrome t o further characterize the. Suchcasesmaymasquerade,asin ourpatient, as a tuberculous pleural effusion,2 or resemble inoperable malignant disease of the pelvis with pleural metastases. Longterm survival in pseudomeigs syndrome caused by ovarian.
We report a challenging case of pseudomeigs syndrome associated with ovarian mucinous carcinoma in a patient with recurrent rightsided exudative, eosinophilic pef without cytologic. Nov 14, 2016 therefore, the prognosis and etiology of pseudomeigs syndrome caused by ovarian metastasis from colorectal cancers remain unclear. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Large uterine leiomyoma presenting as pseudomeigs syndrome. Ca 125, cavity effusions, ovarian cancer, pseudomeigs syndrome. However, when facing such patients, the diagnosis of meigs or pseudomeigs syndrome, conditions that are cured by the removal of a benign tumor, should be taken into account. Meige syndrome genetic and rare diseases information center. Elevated serum ca125 levels were reported in a variety of disease malignancies when serous effusions exist. Meigs syndrome is defined as the presence of ascites and pleural effusion in association with a benign, usually solid ovarian tumor.
Pseudo meigs syndrome refers to a clinical syndrome of pleural effusion, ascites associated with an ovarian tumor that is not a fibroma or a fibromalike tumor. Meigs syndrome is characteristically associated with ovarian fibroma whereas pseudo meigs syndrome is associated with any ovarian or pelvic tumors, other than ovarian. Full text full text is available as a scanned copy of the original print version. Pdf meigs syndrome represents a triad of pleural effusion, ascites, and an ovarian tumor, which is usually benign, occurring together. Pseudo pseudo meigs syndrome ppms is a rarely described clinical entity seen with systemic lupus erythematosus sle. Pseudopseudo meigs syndrome ppms is a newly emerging manifestation of systemic lupus erythematosus sle, characterized by the presence of pleural effusion, ascites and raised ca125 levels. Pseudomeigs syndrome is used to describe cases of ascites andor pleural effusion associated with ovarian neoplasms other than benign tumors, which improve after removal of the ovarian lesion. Medical care of patient with meigs syndrome involves paracentesis and thoracentesis for ascites and pleural effusion respectively. Reported ovarian tumours responsible for pseudomeigs syndrome are struma ovarii tumours, mucinous or serous cystadenomas, germ cell tumours and ovarian metastasis from colon and stomach cancers. We describe here 2 patients with meigs syndrome and 2 patients with pseudomeigs syndrome. Meigs syndrome describes the occurrence of a solid benign ovarian tumor, usually a fibroma, along with the presence of ascites and pleural effusions. In the vast majority 8090% of cases, the primary tumor is an ovarian fibroma.
The tumours may include those of the fallopian tube, uterus, round ligament, mature teratomas, struma ovarii or ovarian leiomyomas, as well as those originating in the colon, breast and stomach 4. Surgery is the mainstay of treatment in pseudomeigs syndrome. The meigs syndrome ms described in 1937 by meigs and cass was characterized by benign ovarian fibroma, ascites and hydrothorax that resolve after the. Meigs syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Hydropic leiomyoma presenting as a rare condition of pseudo. We must call demons pseudo syndrome the association of thoracic andor abdominal effusion with non tumoral affection of the ovary such as endometriosis,hemangioma. Pseudo meigs syndrome has a similar clinical presentation as meigs syndrome pleural effusions andor ascites, with an ovarian mass. Meigs syndrome is characteristically associated with ovarian fibroma whereas pseudomeigs syndrome is associated with any ovarian or pelvic tumors, other than ovarian fibroma. Pseudo meigs syndrome comprises hydrothorax andor ascites secondary to malignant ovarian neoplasms, including ovarian carcinoma or metastatic gastrointestinal malignancies. A 47yearold woman presented with abdominal distention of 1month duration. Not to be confused with meige syndrome or meige disease. A case report divya kallarackal, dharampal singh abstract introduction. Resolution of the ascites and hydrothorax occurs spontaneously following resection of the tumor.
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