Meigs' syndrome with elevated CA 125: case report

Abstract

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

A Case of Meigs’ Syndrome: The 18F-FDG PET/CT Findings

“…High serum carbohydrate antigen 125 (CA-125) level in a postmenopausal woman with associated solid ovarian tumor, ascites, and pleural effusion is highly suggestive of ovarian malignancy. However, patients with Meigs' syndrome can also have elevated levels of serum CA-125 [2,3].…”

Meig’s Syndrome with Elevated CA 125: Case Report with a Journey through Literature

“…Meigs' syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after tumor resection [1][2][3][4]. Despite Meigs` syndrome mimics a malignant condition, it is a benign disease with a very good prognosis if properly treated.…”

“…Several theories have been advanced regarding the pathophysiology of the formation of the ascetic fluid. Mechanical irritation of the peritoneal surfaces by the presence of a hard, solid ovarian tumor could stimulate the production of peritoneal fluid [1][2][3]. Other theories are congestion of the peritoneal lymphatic vessels and regional veins caused by the mass itself, hormonal stimulation or vasoactive substances released by the tumor may result in increased capillary permeability [1,2].…”

“…The occurrence of pleural effusion associated with ascites and an ovarian fibroma or fibro thecoma was first described as a clinical syndrome by Meigs and Cass in 1937 [1][2][3]. Elevated serum carbohydrate antigen 125 (CA 125) leves in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor [1][2][3][4].…”

“…Elevated serum carbohydrate antigen 125 (CA 125) leves in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor [1][2][3][4]. A minority of these patients has a benign condition known as Meigs' syndrome; therefore it is mandatory surgery and histological confirmation of the preoperative diagnosis [2].…”