Pseudo-Meigs syndrome caused by sigmoid colon cancer metastasis to the ovary

Saito, Hiroyasu; Koide, Naoki; Miyagawa, Shinichi

doi:10.1016/j.amjsurg.2010.09.007

Cited by 13 publications

(9 citation statements)

References 6 publications

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“…By definition, lack of evidence for peritoneal or pleural spread of the tumor must have been documented (negative pleural and peritoneal fluid cytology and/or no malignant involvement in biopsy samples) and both ascites and hydrothorax should have resolved after tumor removal. 15,23,24 …”

Section: Methodsmentioning

confidence: 99%

Pleural Effusion in Meigs’ Syndrome—Transudate or Exudate?

et al. 2015

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Although Meigs’ syndrome is regarded as a well-defined entity, contradictory data on pleural fluid characteristics have been presented, with some papers classifying it as a transudate, whereas others stating that it is an exudate.The aims of the study were: (1) to evaluate pleural fluid characteristics in patients with Meigs’ syndrome and (2) to analyze the prevalence of transudative and exudative pleural effusion in relation to the applied definition of the syndrome.We performed a search through medical databases (MEDLINE, EMBASE, SCOPUS, and GOOGLE SCHOLAR) to identify papers on Meigs’ syndrome published between 1940 and 2013. Two authors independently reviewed each paper searching for prespecified data: (1) signs and symptoms, (2) tumor characteristics, (3) clinical and laboratory data on ascites, (4) clinical, radiological, and laboratory data on pleural fluid, (5) clinical course after tumor removal. All case reports were reclassified according to a new unequivocal classification of Meigs’ syndrome-related entities.A total of 653 papers were initially identified, and 454 articles reporting 541 patients were included in the final analysis. After reclassification according to our case definitions, there were 196, 113, and 108 patients defined as classic Meigs’ syndrome, nonclassic Meigs’ syndrome, and pseudo-Meigs’ syndrome, respectively. Significantly more patients presented with right-sided than left-sided and bilateral pleural effusions (P < 0.001). Median volume of withdrawn pleural fluid was 2950 (1500–6000) mL. The classification of pleural effusion with the use of Light's criteria was possible in only 7 patients. In 6 of these patients pleural effusion met the criteria for an exudate. When the protein concentration > 3.0 g/dL was applied as a criterion of pleural exudate, 88.8% (80/90) of effusions were classified as exudates. Increasing the cut-off level to 3.5 g/dL resulted in only a modest decrease in the percentage of exudative effusions (81%, 73/90).Surprisingly few reports on Meigs’ syndrome present data reliably defining the character of pleural effusion. The available data indicate, however, that the majority of pleural effusions in patients with this entity are exudates. This finding may be a prerequisite for the verification of some earlier presented concepts.

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Section: Methodsmentioning

confidence: 99%

Pleural Effusion in Meigs’ Syndrome—Transudate or Exudate?

et al. 2015

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“…Among such cases reported thus far, 8 of the 12 reported patients—including ours—underwent R0 resection, and some showed long-term survival [4–10]. In contrast, long-term survival was not observed in any of the patients that did not undergo R0 resection [4–10].…”

Section: Discussionmentioning

confidence: 94%

“…Secondary ovarian tumors from colorectal gastrointestinal metastases rarely cause pseudo-Meigs’ syndrome; only 11 cases of pseudo-Meigs’ syndrome secondary to colorectal cancers have been reported in the literature (Table 1) [4–10]. Therefore, the prognosis and etiology of pseudo-Meigs’ syndrome caused by ovarian metastasis from colorectal cancers remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Long-term survival in pseudo-Meigs’ syndrome caused by ovarian metastases from colon cancer

et al. 2016

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BackgroundMeigs’ syndrome is defined as the co-existence of benign ovarian fibroma or fibroma-like tumor, ascites, and pleural effusion. In contrast, pseudo-Meigs’ syndrome is defined as the co-existence of other ovarian or pelvic tumors, ascites, and pleural effusion. In Meigs’ and pseudo-Meigs’ syndromes, ascites and pleural effusion resolve promptly after the complete resection of the ovarian or pelvic tumor(s). Secondary ovarian tumors from colorectal gastrointestinal metastases rarely cause pseudo-Meigs’ syndrome; only 11 cases of pseudo-Meigs’ syndrome secondary to colorectal cancers have been reported in the literature. Therefore, the prognosis and etiology of pseudo-Meigs’ syndrome caused by ovarian metastasis from colorectal cancers remain unclear.Case presentationWe report here a rare case of pseudo-Meigs’ syndrome caused by ovarian metastases from sigmoid colon cancer with long-term survival. A 47-year-old woman presented with abdominal distention of 1-month duration. She developed acute dyspnea 2 weeks after the initial presentation. Colonoscopy and computed tomography revealed sigmoid colon cancer with an ovarian metastasis, along with massive ascites and bilateral pleural effusion. Emergency operation, including bilateral oophorectomy and sigmoidectomy, was performed. Subsequently, ascites and bilateral pleural effusion resolved rapidly. Curative hepatic resection was performed for liver metastases 29 months after the first operation, and as of this writing, the patient is alive with no evidence of a disease 78 months after the first operation. In general, colorectal cancer with ovarian metastasis is hard to cure, and long-term survival in patients with colorectal cancer with pseudo-Meigs’ syndrome is rare. Our experience suggests that curative resection for pseudo-Meigs’ syndrome caused by ovarian metastasis from colorectal cancer may offer long-term survival.ConclusionsOur experience suggests that pseudo-Meigs’ syndrome can occur in a patient with colorectal cancer after metastasis to the ovaries, causing massive ascites and pleural effusion. Aggressive treatment, including R0 resection, for this disease if allowed by the patient’s general condition may offer long-term survival.

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“…On the other hand, pseudo-Meigs syndrome is a similar condition associated with pelvic tumors, except for the fact that these ovarian tumors are benign, such as primary ovarian malignancies, ovarian metastasis of gastrointestinal malignancies, uterine leiomyomas and so on. [3][4][5][6][7][8] Pseudo-Meigs syndrome due to uterine leiomyoma is very rare. Here we report a patient case of pseudo-Meigs syndrome caused by a giant uterine leiomyoma with cystic degeneration, which was initially suspected to be a case of ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%

“…3 A number of studies have reported cases of Pseudo-Meigs syndrome associated with struma ovarii, mature teratoma, uterine myoma, ovarian cancer and ovarian metastasis of malignancies. The Pseudo-Meigs syndrome is often diagnosed upon close examination and classically during follow-up appointments subsequently to the treatment of other malignanttumors [4][5][6][7][8]. The pathophysiology or the origin of the ascites and pleural effusion found in patients presenting either the Meigs or the pseudo-Meigs syndrome remains uncertain.…”

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confidence: 99%

Pseudo-Meigs Syndrome Caused by a Giant Uterine Leiomyoma with Cystic Degeneration: A Case Report

et al. 2020

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Pseudo-Meigs syndrome is defined as the secondary accumulation of ascites and hydrothorax associated with pelvic tumor other than benign ovarian tumor such as fibroma, which classically resolve upon surgical removal of the tumor. Here we report a case of pseudo-Meigs syndrome caused by a giant uterine leiomyoma, which was initially suspected to be ovarian cancer. A 37-year old nulliparous woman presented with a 5-month history of abdominal distension and anorexia. Abdominal ultrasonography revealed the presence of a giant cystic lesion and solid mass in the peritoneal cavity along with a massive ascites. Chest X-ray images showed a small pleural effusion on the right side. Because general physicians suspected ovarian cancer and peritonitis carcinomatosis, the patient was referred to our hospital. Although the CA125 serum level was elevated (up to 331.8 U/ml), magnetic resonance imaging (MRI) showed the presence a giant sub-serosal uterine leiomyoma with cystic 2 degeneration, with dimensions 27×15×13 cm. A small dermoid cyst was also detected in the right ovary. The ascites was surgically removed and the patient underwent myomectomy and ovarian cystectomy. We concluded that the patient presented a degenerated leiomyoma with no pathological evidence of malignancy. And because the symptoms of the patient disappeared postoperatively and her CA125 serum levels returned to normal without recurrence of ascites, the patient was diagnosed with pseudo-Meigs syndrome.

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Pseudo-Meigs syndrome caused by sigmoid colon cancer metastasis to the ovary

Cited by 13 publications

References 6 publications

Pleural Effusion in Meigs’ Syndrome—Transudate or Exudate?

Pleural Effusion in Meigs’ Syndrome—Transudate or Exudate?

Long-term survival in pseudo-Meigs’ syndrome caused by ovarian metastases from colon cancer

Pseudo-Meigs Syndrome Caused by a Giant Uterine Leiomyoma with Cystic Degeneration: A Case Report

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