Mohammed Shahid A., Kumar Abhishek, Cue Lauren
Michigan State University/Spectrum Health
Albert Einstein College of Medicine
Meigs syndrome is characterized by benign ovarian tumors that present with ascites and pleural effusions. Approximately 1% of ovarian tumors have this presentation, and due to their similar clinical features, differentiating Meigs syndrome from malignant tumors can be challenging. This syndrome was first reported by Joe Vincent Meigs in 1937 in a series of 7 cases where patients presented with an ovarian fibroma and associated ascites and hydrothorax. Although the association between benign ovarian tumors and pleural effusion (analogous with the finding of hydrothorax) had been reported in earlier cases, Meigs was the first to describe the resolution of ascites and pleural effusion after surgical removal of the tumor and an otherwise benign postoperative course. In 1954, Meigs officially established the following diagnostic criteria for Meigs syndrome: : Presence of a benign ovarian tumor, such as fibroma, thecoma, granulosa cell tumor, or Brenner tumor. Ascites. Pleural effusion. Resolution of ascites and pleural effusion following tumor removal . Pericardial effusion is not included in the definition of Meigs syndrome; however, there have been case reports of patients with unexplained persistent pericardial effusion that resolved after the removal of a benign ovarian tumor. Meigs syndrome typically presents in postmenopausal women with dyspnea, dry cough, and painful abdominal distension. Physical examination may reveal adnexal masses, diminished breath sounds, and signs of ascites. Meigs syndrome most commonly affects postmenopausal women; however, when identified in younger individuals, it should prompt considerations of Gorlin syndrome, a familial cancer syndrome. Diagnostic evaluation involves a thorough history, physical examination, and imaging to confirm the presence of a pelvic mass and exclude malignancies. Laboratory studies and fluid analysis are also crucial in the diagnostic process. The resolution of ascites and pleural effusion after tumor removal confirms the diagnosis. Treatment primarily involves the surgical removal of the ovarian mass. In young women desiring fertility preservation, a unilateral salpingo-oophorectomy is preferred, whereas postmenopausal women may undergo total abdominal hysterectomy with bilateral salpingo-oophorectomy. For patients unsuitable for surgery, symptomatic treatment options include paracentesis, thoracentesis, and the placement of indwelling catheters for fluid management.
梅格斯综合征的特征是良性卵巢肿瘤伴有腹水和胸腔积液。约1%的卵巢肿瘤有此表现，由于其临床特征相似，将梅格斯综合征与恶性肿瘤区分开来可能具有挑战性。该综合征于1937年由乔·文森特·梅格斯首次报道，在一组7例患者中，患者表现为卵巢纤维瘤及相关腹水和胸腔积液。尽管在早期病例中已报道过良性卵巢肿瘤与胸腔积液（类似于胸腔积液的发现）之间的关联，但梅格斯是第一个描述肿瘤手术切除后腹水和胸腔积液消退以及术后病程良性的人。1954年，梅格斯正式确立了梅格斯综合征的以下诊断标准：存在良性卵巢肿瘤，如纤维瘤、卵泡膜瘤、颗粒细胞瘤或勃勒纳瘤；腹水；胸腔积液；肿瘤切除后腹水和胸腔积液消退。心包积液不包括在梅格斯综合征的定义中；然而，有病例报告称，原因不明的持续性心包积液患者在切除良性卵巢肿瘤后积液消退。梅格斯综合征通常发生在绝经后女性，表现为呼吸困难、干咳和腹部胀痛。体格检查可能发现附件肿块、呼吸音减弱和腹水体征。梅格斯综合征最常影响绝经后女性；然而，在较年轻个体中发现时，应考虑戈林综合征，一种家族性癌症综合征。诊断评估包括详细的病史、体格检查和影像学检查，以确认盆腔肿块的存在并排除恶性肿瘤。实验室检查和液体分析在诊断过程中也至关重要。肿瘤切除后腹水和胸腔积液的消退可确诊。治疗主要包括手术切除卵巢肿块。对于希望保留生育能力的年轻女性，首选单侧输卵管卵巢切除术，而绝经后女性可能接受全腹子宫切除术及双侧输卵管卵巢切除术。对于不适合手术的患者，对症治疗选择包括腹腔穿刺、胸腔穿刺以及放置留置导管进行液体管理。
