Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
J Obstet Gynaecol Res. 2023 Aug;49(8):2199-2204. doi: 10.1111/jog.15677. Epub 2023 May 17.
Symptoms of pelvic masses, elevated serum CA125 levels, massive ascites, and pleural effusion in female patients are usually associated with malignancy. Some benign ovarian tumors or other nonmalignant tumors may also produce similar symptoms, called Meigs syndrome or pseudo-Meigs' syndrome, which should be one of the differential diagnoses. However, there is an extremely rare form of SLE called pseudo-pseudo Meigs syndrome (PPMS), which may also present with the above symptoms, but is not associated with any of the tumors. In this paper, we report a case of a 47-year-old woman who presented with abdominal distention. The patient was found to have elevated serum CA125 levels to 182.9 U/mL before the operation. Her PET-CT suggested a large heterogeneous mass in the pelvis measuring 8.2 × 5.8 cm with a large amount of ascites. She was initially diagnosed with ovarian cancer and underwent exploratory laparotomy. Pathology of the surgical specimen revealed a uterine leiomyoma. Two months after discharge, the patient's ascites reappeared along with recurrent intestinal obstruction. After ascites and serological tests, she was eventually diagnosed with systemic lupus erythematosus and received systemic hormonal therapy.
女性患者出现盆腔包块、血清 CA125 水平升高、大量腹水和胸腔积液等症状通常与恶性肿瘤有关。一些良性卵巢肿瘤或其他非恶性肿瘤也可能产生类似的症状，称为梅格斯综合征或假性梅格斯综合征，这应该是鉴别诊断之一。然而，有一种极其罕见的系统性红斑狼疮称为假性假性梅格斯综合征（PPMS），也可能出现上述症状，但与任何肿瘤均无关。本文报道了 1 例 47 岁女性患者，因腹胀就诊。患者术前血清 CA125 水平升高至 182.9 U/mL。其 PET-CT 提示盆腔内有一个 8.2×5.8cm 的巨大混杂性肿块，伴有大量腹水。最初诊断为卵巢癌，并进行了剖腹探查术。手术标本的病理检查显示为子宫平滑肌瘤。出院后 2 个月，患者再次出现腹水并伴有反复肠梗阻。在进行腹水和血清学检查后，最终诊断为系统性红斑狼疮，并接受了全身激素治疗。
