Pseudo-Meigs’ syndrome due to ovarian metastases from colon cancer: a case report and review of the literature

Abstract

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.

Pseudo-Meigs’ syndrome secondary to breast cancer with ovarian metastasis: a case report and literature review

“…Ovarian metastases account for 15% of ovarian tumors, mainly from organs such as the gastrointestinal tract ( 8 – 10 ) and the endometrium ( 11 ). The ovarian metastasis rate from the breast differs significantly, accounting for approximately 1.8-38% ( 12 – 14 ).…”

Embryological, anatomical and clinical considerations on pleuroperitoneal communication

“…Meigs syndrome is the triad of the ovarian fibroma (or thecoma, granulosa cell tumor, Brenner tumor), ascites, and pleural effusion [ 43 , 44 ]. Pseudo-Meigs syndrome is the presence of an ovarian or pelvic tumor (either benign or malignant), ascites, and pleural effusion [ 45 ]. Meigs and pseudo-Meigs syndrome share a common pathophysiology and clinical presentation but differ in primary etiology and treatment.…”

“…Ovarian fibroma in Meigs syndrome is a benign ovarian neoplasm. Instead, the pseudo-Meigs syndrome has been associated with uterine leiomyoma, primary and metastatic malignant ovarian neoplasm due to gastric, breast, and colorectal cancer [ 45 ]. Two theories have been proposed for the pathogenesis of ascites in both syndromes.…”

Pegylated liposomal‑paclitaxel induces ovarian cancer cell apoptosis via TNF‑induced ERK/AKT signaling pathway

“…Ovarian cancer exhibits high rates of mortality compared with other gynecological malignances ( 1 ). Investigations into the pathogenesis of ovarian cancer have reported that diagnosis occurs within the later stages of pathogenesis, which has been associated with lower overall survival rates ( 2 , 3 ). Previous studies have reported that ovarian cancer metastasizes throughout the peritoneal cavity and numerous organs may be affected during the pathogenesis of ovarian cancer ( 4 , 5 ).…”