Meigs’ syndrome mimicking heart failure with preserved ejection fraction: a case report

Abstract

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.

Successful management of a patient with preoperative respiratory failure due to a solid giant retroperitoneal tumor: a case report

“…Supporting this possibility, the patient’s postoperative transthoracic echocardiography demonstrated that the degree of aortic and mitral regurgitation had become trivial at 1-month post-surgery. However, surgical resection is preferred in Meigs syndrome with similar symptoms such as respiratory failure and pleural effusion because diuretics are ineffective [ 8 ].…”

Sclerosing Stromal Tumor of the Ovary Presenting as Meigs Syndrome During Childhood

“…Its presentation with a triad of ascites, pleural effusion, and ovarian tumor, which is more often seen in more serious conditions, makes it challenging to diagnose Meigs syndrome, a benign disease [ 6 ]. Malignant conditions presenting as adnexal masses in pediatric and adolescent patients include germ cell tumors, sex cord-stromal tumors, epithelial ovarian tumors, and metastatic tumors [ 7 ].…”

Case Report: Ovarian fibroma: typical presentation with Meigs’s Syndrome

“…Because several conditions are linked to the development of these common indications, the correct diagnosis and treatment are frequently missed. 7 The cause of Meigs’s condition is still unknown. Ascites are a common symptom of ovarian tumors, and numerous causes have been proposed, including tumor torsion and restriction of venous drainage.…”