Abdelgawad Mohamed, Barghuthi Lutfi, Davis Tyler, Omar Mahmoud, Kamel Omar M, Gibbons Jake, Ragoza Yury, Ismael Hishaam
Department of Surgery, University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA.
Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA.
J Surg Case Rep. 2022 Jun 7;2022(6):rjac253. doi: 10.1093/jscr/rjac253. eCollection 2022 Jun.
Ascites, pelvic mass and elevated CA-125 in females carry a grim prognosis, likely an ovarian carcinoma. However, more benign etiologies such as Meigs' and pseudo-Meigs' syndrome must be considered. Pseudo-Meigs' syndrome presenting with an elevated CA-125 is rare and presents a diagnostic challenge. Medline and PubMed were queried for pseudo-Meigs' syndrome cases. We present a 35-year-old female patient who presented with abdominal swelling and weight gain. Imaging demonstrated a 29-cm large intraabdominal mass with significant ascites with elevation of CA-125. Surgical resection was performed, and pathology identified uterine leiomyoma. Twenty-one cases of pseudo-Meigs' syndrome were identified in the literature. Most patients presented with abdominal distention, and some also reported dyspnea. All patients, including our case, were treated surgically. No recurrence reported among these cases. Surgery is the mainstay for radical treatment in pseudo-Meigs' syndrome. Resolution of the ascites and hydrothorax occurs following resection of the tumor.
女性出现腹水、盆腔肿块和CA - 125升高预后不佳，很可能是卵巢癌。然而，必须考虑更多良性病因，如梅格斯综合征和假性梅格斯综合征。表现为CA - 125升高的假性梅格斯综合征罕见，且具有诊断挑战性。我们检索了医学文献数据库（Medline）和美国国立医学图书馆生物医学信息数据库（PubMed）以查找假性梅格斯综合征病例。我们报告一名35岁女性患者，她出现腹部肿胀和体重增加。影像学检查显示腹腔内有一个29厘米大的肿块，并伴有大量腹水，CA - 125升高。进行了手术切除，病理检查确诊为子宫平滑肌瘤。在文献中我们共找到21例假性梅格斯综合征病例。大多数患者表现为腹部膨隆，部分患者还伴有呼吸困难。所有患者，包括我们的病例，均接受了手术治疗。这些病例均未报告复发情况。手术是假性梅格斯综合征根治性治疗的主要方法。切除肿瘤后腹水和胸腔积液会消退。
