1.Struma ovarii-associated pseudo-Meigs−syndrome with concomitant abdominopelvic tuberculosis masquerading as ovarian malignancy
Nicole Anna Marie H. Dionisio ; Elizabeth K. Jacinto
Philippine Journal of Obstetrics and Gynecology 2021;45(6):244-249
		                        		
		                        			
		                        			Pseudo-Meigs' syndrome (PMS) is a rare disease characterized by the triad of (1) an ovarian neoplasm, other than a fibroma or thecoma, (2) ascites, and (3) pleural effusion. Tumors such as struma ovarii, mucinous and serous cystadenomas, and germ cell tumors have been linked with the condition. Due to its clinical features combined with the elevation of serum cancer antigen 125 (CA-125) levels, it is often mistaken and treated as a malignant ovarian tumor. Ascites or pleural effusion could be massive leading to various life-threatening complications. Despite its presentation, this entity has an excellent prognosis when surgical excision of the tumor is performed. This article presents an unusual case of a 41-year-old gravida 10 para 10 (10-0-0-9) who was diagnosed with a case of struma ovarii associated PMS with concomitant abdominopelvic tuberculosis and elevated CA-125 resembling an ovarian malignancy.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			 Struma Ovarii
		                        			;
		                        		
		                        			 Meigs Syndrome
		                        			;
		                        		
		                        			 CA-125 Antigen
		                        			;
		                        		
		                        			 Abdominal Neoplasms
		                        			
		                        		
		                        	
2.Clinical laboratory features of Meigs' syndrome: a retrospective study from 2009 to 2018.
Wenwen SHANG ; Lei WU ; Rui XU ; Xian CHEN ; Shasha YAO ; Peijun HUANG ; Fang WANG
Frontiers of Medicine 2021;15(1):116-124
		                        		
		                        			
		                        			Meigs' syndrome (MS), a rare complication of benign ovarian tumors, is easily misdiagnosed as ovarian cancer (OC). We retrospectively reviewed the clinical laboratory data of patients diagnosed with MS from 2009 to 2018. Serum carbohydrate antigen 125 and HE4 levels were higher in the MS group than in the ovarian thecoma-fibroma (OTF) and healthy control groups (all P < 0.05). However, the serum HE4 levels were lower in the MS group than in the OC group (P < 0.001). A routine blood test showed that the absolute counts and percentages of lymphocytes were significantly lower in the MS group than in the OTF and control groups (all P < 0.05). However, these variables were higher in the MS group than in the OC group (both P < 0.05). The neutrophil-to-lymphocyte ratio (NLR) was also significantly lower, whereas the lymphocyte-to-monocyte ratio was higher in the MS group than in the OC group (both P < 0.05). The NLR, platelet-to-lymphocyte ratio, and systemic immune index were significantly higher in the MS group than in the OTF and control groups (all P < 0.05). The hypoxia-inducible factor-1 mRNA levels were also significantly higher, whereas the glucose transporter 1, lactate dehydrogenase, and enolase 1 mRNA levels were lower in peripheral CD4
		                        		
		                        		
		                        		
		                        			Carcinoma, Ovarian Epithelial
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fibroma
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laboratories
		                        			;
		                        		
		                        			Meigs Syndrome/diagnosis*
		                        			;
		                        		
		                        			Ovarian Neoplasms
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
3.Meigs' Syndrome with Elevated Cancer Antigen 125.
Hye Na PARK ; Sun Gyoeng KIM ; Yun Sook KIM
Soonchunhyang Medical Science 2016;22(2):129-131
		                        		
		                        			
		                        			Meigs' syndrome is a fibroma associated with ascites and/or pleural effusion and several cases have been reported in association with elevated serum cancer antigen (CA) 125 level. We report here on a 72-year-old woman who presented with palpable huge pelvic mass. Abdomen and pelvic computed tomography showed a heterogenous huge pelvic mass measuring 210×110 mm with large amount of ascites. No pleural effusion was detected on chest X-ray. CA 125 level was 327 IU/mL. The patient underwent laparotomy during which a mass measuring 210×110 mm was detected in her right ovary with 1,000 mL of ascites. Histology showed ovarian fibroma. We performed total abdominal hysterectomy with bilateral salpingo-oophorectomy. Postmenopausal woman with ovarian tumor, ascites, and elevated CA 125 may indicate malignant ovarian tumor, but Meigs' syndrome must be considered as differential diagnosis.
		                        		
		                        		
		                        		
		                        			Abdomen
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			CA-125 Antigen
		                        			;
		                        		
		                        			Diagnosis, Differential
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fibroma
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hysterectomy
		                        			;
		                        		
		                        			Laparotomy
		                        			;
		                        		
		                        			Meigs Syndrome*
		                        			;
		                        		
		                        			Ovary
		                        			;
		                        		
		                        			Pleural Effusion
		                        			;
		                        		
		                        			Thorax
		                        			
		                        		
		                        	
4.Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report.
Journal of Menopausal Medicine 2015;21(1):56-59
		                        		
		                        			
		                        			Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated cancer antigen 125 (CA-125) in Meigs' syndrome is an unusual clinical condition reported in few cases. We report here on a 61-year-old woman who presented with dyspnea; in imaging assessment, a heterogeneous pelvic mass measuring 12 x 11 cm with ascitic fluid was reported. Pleural effusion was detected on Chest X-ray. Aspiration of pleural fluid showed no evidence of malignancy. CA-125 level was 347 IU/mL. The patient underwent laparotomy during which a mass measuring 12 x 11 cm was detected in her left adnexa. Histology showed ovarian thecoma. The mass was resected, and, after that, the symptoms disappeared and CA-125 level reached 19 IU/mL. The patient had experienced no problem after 12 months of follow up. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA-125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Ascitic Fluid
		                        			;
		                        		
		                        			Diagnosis, Differential
		                        			;
		                        		
		                        			Dyspnea
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laparotomy
		                        			;
		                        		
		                        			Meigs Syndrome*
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Pleural Effusion
		                        			;
		                        		
		                        			Thecoma
		                        			;
		                        		
		                        			Thorax
		                        			
		                        		
		                        	
5.A Case of Tjalma Syndrome Coincidentally Accompanied by an Ovarian Teratoma Successfully Treated with Intravenous Immunoglobulin-G Adjunctive Therapy.
Eun Kyoung PARK ; Seung Geun LEE ; Ik Soo BYON ; Sun Hee LEE ; Seong Jun LEE ; Yoon Jeong NAM ; Ji Hye PARK ; Geun Tae KIM ; Young Eun PARK ; Seong Hu PARK ; Joung Wook LEE ; Jun Hee LEE ; Seung Hoon BAEK
Journal of Rheumatic Diseases 2014;21(2):77-81
		                        		
		                        			
		                        			Tjalma or pseudo-pseudo Meigs' syndrome is a clinical condition that is characterized with ascites, pleural effusion, and increased serum CA-125 levels in patients with systemic lupus erythematosus (SLE) without the presence of ovarian tumor. On the other hand, Meigs' and pseudo-Meigs' syndromes represent the same manifestations with ovarian tumor. In this case report, we present a 43-year-old SLE patient suffering from Tjalma syndrome with the coexistence of incidental ovarian teratoma, who was successfully treated with intravenous immunoglobulin-G adjunctive therapy after inadequate response to surgical excision of the ovarian tumor, steroid, and cyclophosphamide pulse therapy.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Cyclophosphamide
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lupus Erythematosus, Systemic
		                        			;
		                        		
		                        			Meigs Syndrome
		                        			;
		                        		
		                        			Pleural Effusion
		                        			;
		                        		
		                        			Teratoma*
		                        			
		                        		
		                        	
6.A case of Meigs' syndrome with elevated serum CA 125 level.
Eun Jung JI ; Jung Mi HAN ; Cheol Yong MOON ; Ji Youn JUNG ; Eun Sook NAM ; Pong Rheem JANG ; Keun Young LEE ; Yong Il KWON
Korean Journal of Obstetrics and Gynecology 2008;51(8):915-919
		                        		
		                        			
		                        			Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated CA 125 in Meigs'syndrome is unusual clinical condition reported in few cases. We report here, a 49-year-old postmenopausal woman with right ovarian fibrothecoma with ascites, right pleural effusion and high serum levels of CA 125. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA 125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Diagnosis, Differential
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Meigs Syndrome
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Ovary
		                        			;
		                        		
		                        			Pleural Effusion
		                        			
		                        		
		                        	
7.Meigs' syndrome with elevated serum CA125 level.
Gi Hyun KIM ; Mi Sook LEE ; Kyung Jae SHIN ; Yong Seob LEE
Korean Journal of Obstetrics and Gynecology 2006;49(6):1359-1363
		                        		
		                        			
		                        			Meigs' syndrome is characterized by the pleural effusion and ascites in patient with solid benign ovarian tumors and the resolution of the effusion after resection of the tumor. Elevated serum CA125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovary tumor. We present a case of Meigs' syndrome with elevated serum CA125.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Meigs Syndrome*
		                        			;
		                        		
		                        			Ovary
		                        			;
		                        		
		                        			Pleural Effusion
		                        			
		                        		
		                        	
8.A case of Meigs' syndrome and sclerosing peritonitis associated with fibrothecoma of bilateral ovary.
Yong Il JI ; Mee Won SEO ; Eun Mee HAN ; Dae Yeon KIM ; Dae Sil SUH ; Jong Hyeok KIM ; Yong Man KIM ; Young Tak KIM ; Joo Hyun NAM
Korean Journal of Obstetrics and Gynecology 2006;49(7):1592-1596
		                        		
		                        			
		                        			Fibrothecoma is mesenchymal tumor deriving from the ovarian stroma composed of theca-like elements and fibrous tissues. Fibroma is rarely associated with Meigs' syndrome which consists of an ovarian fibroma, ascites, and pleural effusion. And also, sclerosing peritonitis associated with thecoma of the ovary is a rare, but intriguing phenomenon characterized by striking peritoneal reactive fibrosis. We have experienced a case of Meigs' syndrome and sclerosing peritonitis associated with fibrothecoma of the bilateral ovaries in a 57-year-old woman. We report a case with brief review of literatures.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fibroma
		                        			;
		                        		
		                        			Fibrosis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Meigs Syndrome*
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Ovary*
		                        			;
		                        		
		                        			Peritonitis*
		                        			;
		                        		
		                        			Pleural Effusion
		                        			;
		                        		
		                        			Strikes, Employee
		                        			;
		                        		
		                        			Thecoma
		                        			
		                        		
		                        	
9.1 case of Meigs' syndrome with markedly elevated serum CA 125 level.
Korean Journal of Obstetrics and Gynecology 2006;49(5):1125-1130
		                        		
		                        			
		                        			Meigs' syndrome is named when benign and solid ovarian tumors with the gross appearance of a fibroma is accompanied by ascites and pleural effusion, which disappear after removal of the ovarian tumors. Ovarian tumors with markedly elevated CA 125 level are highly suggestive of ovarian malignancy but, patients with Meigs' syndrome can have elevated serum CA 125 levels as well. We present a 75-year-old woman's case of Meigs' syndrome with markedly elevated serum CA 125 level (1,068 IU/mL).
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fibroma
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Meigs Syndrome*
		                        			;
		                        		
		                        			Pleural Effusion
		                        			
		                        		
		                        	
10.A case of Pseudo-Meigs' syndrome with Brenner tumor.
So Hee KIM ; Jin Hee KIM ; Mi Sun PARK ; Hak Youle PARK ; Dong Ja KIM
Korean Journal of Gynecologic Oncology 2006;17(2):173-178
		                        		
		                        			
		                        			Meigs' syndrome is defined by the presence of ascites and hydrothorax in association with an ovarian fibroma, which spontaneously resolve soon after the removal of the tumor. Pseudo-Meigs' syndrome is rare syndrome associated with struma ovarii, yolk sac tumor, ovarian carcinoma, leiomyoma, Brenner tumor and tuberculosis which is combined with the same clinical feature. The cause and pathophysiology of Pseudo-Meigs' syndrome are uncertain. The diagnosis is done by characteristic clinical finding. We present a case of Pseudo-Meigs' syndrome with Brenner tumor with brief review of the literatures.
		                        		
		                        		
		                        		
		                        			Ascites
		                        			;
		                        		
		                        			Brenner Tumor*
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Endodermal Sinus Tumor
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fibroma
		                        			;
		                        		
		                        			Hydrothorax
		                        			;
		                        		
		                        			Leiomyoma
		                        			;
		                        		
		                        			Meigs Syndrome
		                        			;
		                        		
		                        			Struma Ovarii
		                        			;
		                        		
		                        			Tuberculosis
		                        			
		                        		
		                        	
            

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