Pseudo‐Meigs' syndrome associated with hydropic degenerating uterine leiomyoma: A case report

Abstract

Pseudo-Meigs' syndrome secondary to uterine leiomyoma is a rare entity. A 50-year-old Japanese woman presented with a 3-month history of shortness of breath. Chest X-ray and magnetic resonance imaging revealed massive right pleural effusion, ascites and a large subserosal uterine myoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The pathology was consistent with a benign leiomyoma. The ascites and pleural effusion rapidly disappeared postoperatively. The serum interleukin-6 level was 3.9 pg/mL before surgery and declined to 1.6 pg/mL postoperatively. Previous published work has demonstrated that vascular endothelial growth factor and interleukin-6 may play a role in the pathogenesis of Meigs' syndrome and that vascular endothelial growth factor may contribute to the development of pseudo-Meigs' syndrome due to metastatic ovarian cancer. This is the first English-language study showing the possibility that interleukin-6 is relevant to the pathogenesis of pseudo-Meigs' syndrome caused by degenerating uterine leiomyoma.

Hydropic leiomyoma: a distinct variant of leiomyoma closely related to HMGA2 overexpression

“…Our patient population overall was found to be similar to the patients seen in reported HLM cases from the literature. The patients in our series clinically presented as women of reproductive age (average age 43.79⨦12.7 years), similar to the reported cases from the literature with a median age 42 years (range 26-50) [4,[9][10][11][12][13][14][15][16][17][18][19]. Presenting symptoms of our patients and reported cases resembled those of other female reproductive organ masses [9][10][11][12][13][14][15][16][17][18].…”

“…Interestingly, one patient's HLM from this study and three reported cases manifested during pregnancy either as acute or chronic complications [10][11][12]. Another unexpected presentation observed in reported cases (seven in total) was pseudo-Meigs syndrome: shortness of breath and pleural effusion with a concurrent pelvic or abdominal mass, elevated serum CA-125, and, in some patients, ascites [13][14][15].…”

Abdominopelvic leiomyoma with large ascites: a case report and literature review

“…Uterine leiomyomas that present as pseudo-Meigs syndrome have already been described in the literature [11][12][13][14]. However, few cases of pseudo-Meigs syndrome in which a leiomyoma is implanted on the omentum have been reported [15]. In this study, we report a massive abdominopelvic leiomyoma with large ascites in a 22year-old woman.…”

Meigs’ syndrome with elevated CA-125 and HE-4: a case of luteinized fibrothecoma

“…There are reports suggesting that proinflammatory cytokines – interleukin (IL) 6, IL-1βi, IL-8, vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) – play an important role in ascites, hydrothorax or pleurocardia [ 13 ]. Numerous Meigs’ syndrome cases were described as related to increased levels of CA-125 [ 14 , 15 ]. CA-125 is a glycoprotein, in humans encoded by the MUC16 gene on chromosome 19 [ 3 ].…”