Yuan Liqin, Cui Lin, Wang Jie, Gong Li
Department of Gynecology, Rizhao People's Hospital, Rizhao, Shandong Province, 276800, People's Republic of China.
Int J Womens Health. 2024 Mar 23;16:519-525. doi: 10.2147/IJWH.S450833. eCollection 2024.
Meigs' syndrome is a rare gynecological disease characterized by the triad of benign ovarian tumor, ascites, and pleural effusion. Ovarian malignancies should be highly suspected in a postmenopausal woman with a pelvic mass, ascites, hydrothorax, and an elevated carbohydrate antigen 125 (CA125) level. It can be challenging to make a preoperative diagnosis of Meigs' syndrome. In this report, we present a case of Meigs' syndrome caused by an ovarian fibrothecoma and review the relevant literature to raise awareness and avoid misdiagnosis.
An 82-year-old woman with a 2-week history of abdominal distension was admitted to the Department of Gynecology. Ultrasound and thoracoabdominal computed tomography scans showed a left-sided hypoechoic mass in the pelvic cavity with bilateral pleural effusion and massive ascites. The CA125 concentration was 1040 U/mL (normal, 0-35 U/mL). With a working diagnosis of ovarian malignancy, the patient underwent ultrasound-guided fine-needle puncture of the pelvic mass and paracentesis to drain the ascites. The fine-needle puncture and paracentesis fluid analysis results revealed that the ascites did not contain any tumor cells, and the pelvic mass was identified as a spindle cell tumor. Immunohistochemistry confirmed that it was a sex-cord stromal tumor. Total abdominal hysterectomy and bilateral adnexectomy were performed under general anesthesia. The pathology results confirmed the mass to have been an ovarian fibrothecoma. At the 2-month postoperative follow-up, the ascites and hydrothorax had resolved and not recurred, and the CA125 level was normal.
Despite the high suspicion of ovarian carcinoma in postmenopausal women presenting with pelvic mass, ascites, pleural effusion, and elevated CA125, Meigs' syndrome should be considered.
梅格斯综合征是一种罕见的妇科疾病，其特征为良性卵巢肿瘤、腹水和胸腔积液三联征。对于有盆腔肿块、腹水、胸腔积液且糖类抗原125（CA125）水平升高的绝经后女性，应高度怀疑卵巢恶性肿瘤。术前诊断梅格斯综合征可能具有挑战性。在本报告中，我们呈现了一例由卵巢纤维瘤引起的梅格斯综合征病例，并回顾相关文献以提高认识并避免误诊。
一名82岁女性，有2周腹胀病史，入住妇科。超声和胸腹计算机断层扫描显示盆腔左侧低回声肿块，伴有双侧胸腔积液和大量腹水。CA125浓度为1040 U/mL（正常范围0 - 35 U/mL）。初步诊断为卵巢恶性肿瘤，患者接受了超声引导下盆腔肿块细针穿刺及腹腔穿刺放腹水。细针穿刺和腹腔穿刺液分析结果显示腹水中未发现任何肿瘤细胞，盆腔肿块被确定为梭形细胞瘤。免疫组化证实为性索间质肿瘤。在全身麻醉下进行了全腹子宫切除术和双侧附件切除术。病理结果证实肿块为卵巢纤维瘤。术后2个月随访时，腹水和胸腔积液已消退且未复发，CA125水平正常。
尽管对于出现盆腔肿块、腹水、胸腔积液及CA125升高的绝经后女性高度怀疑卵巢癌，但仍应考虑梅格斯综合征。
