Abstract

Case Report

A case report on Meigs’ syndrome and elevated serum CA-125: A rare case report

Divya Khanduja* and NC Kajal

Published: 24 March, 2021 | Volume 5 - Issue 1 | Pages: 031-033

Meigs syndrome is an uncommon presentation, where a benign ovarian neoplasia presents along with ascites and pleural effusion. About 1% of ovarian neoplasia can present as Meigs syndrome. Patients with Meigs’ syndrome and elevated serum CA-125 are not frequently reported. We report a case of a 50-year-old women who presented with shortness of breath, cough, weight loss of one and half month duration. Chest radiograph of the patient with clinical examination of patient confirms pleural effusion as cause of progressive shortness of breath. The presence of a pelvic mass and elevated serum CA-125, which raised the possibility of malignancy. After complete resection of tumor, the pathologic reports confirmed a benign ovarian neoplasia. We highlight the importance of suspicion, careful general examination, radiological assessment and histological tests to confirm the diagnosis of Meigs’ syndrome.

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Keywords:

Meigs’ syndrome; CA-125; Exudative pleural effusion; Benign ovarian neoplasia

References

  1. Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting Meigs syndrome. J Bronchology Interv Pulmonol. 2013; 20: 48-51. PubMed: https://pubmed.ncbi.nlm.nih.gov/23328144/
  2. Saha S, Robertson M, Meigs' and Pseudo-Meigs' syndrome. Australas J Ultrasound Med. 2012; 15: 29-31. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025132/
  3. Shiau CS, Chang MY, Hsieh CC, Hsieh TT, Chiang CH. Meigs' syndrome in a young woman with a normal serum CA-125 level. Chang Gung Med J. 2005; 28: 587-591. PubMed: https://pubmed.ncbi.nlm.nih.gov/16265850/
  4. Kwan BCH, Light RW. Effusions associated with gynecologic and obstetric conditions. In: Textbook of Pleural Diseases, 3rd Ed.. Light RW, Gary Lee YC (ed): CRC Press, Taylor & Francis Group. 2016; 427: 39.
  5. Quirk JT, Natarajan N. Ovarian cancer incidence in the United States, 1992-1999. Gynecol Oncol. 2005; 97: 519-523. PubMed: https://pubmed.ncbi.nlm.nih.gov/15863154/
  6. Krenke R, Maskey-Warzechowska M, Korczynski P, Zielinska-Krawczyk M, Klimiuk J, et al. Pleural effusion in Meigs' syndrome - transudate or exudate?: systematic review of the literature. Medicine (Baltimore). 2015; 94: 2114. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008483/
  7. Brun JL. Demons syndrome revisited: a review of the literature. Gynecol Oncol. 2007; 105: 796-800. PubMed: https://pubmed.ncbi.nlm.nih.gov/17433421/
  8. Peparini N, Chirletti P. Ovarian malignancies with cytologically negative pleural and peritoneal effusions: demons' or Meigs' pseudo-syndromes? Int J Surg Pathol. 2009; 17: 396-397. PubMed: https://pubmed.ncbi.nlm.nih.gov/19448068/
  9. Bedawi EO, Hassan M, Rahman NM. Recent developments in the management of pleural infection: A comprehensive review. Clin Respir J. 2018; 2(8):2309-2320. PubMed: https://pubmed.ncbi.nlm.nih.gov/30005142/
  10. Lepus CM, Vivero M. Updates in Effusion Cytology. Surg Pathol clin. 2018; 11: 523-544. PubMed: https://pubmed.ncbi.nlm.nih.gov/30190139/
  11. Reddy SL, Varaprasad K, Narahari N, Bhaskar K, Varma GR, et al. Clinical and etiological profile of an exudative pleural effusion in a tertiary care center. Indian J Respir Care. 2019; 8: 22-26. http://www.ijrc.in/text.asp?2019/8/1/22/249355
  12. Murayma, et al. BMC Cardiovascular Disorders.
  13. CA 125 test. 2020. https://www.mayoclinic.org/tests-procedures/ca-125-test/about/pac-20393295
  14. Johnson CC, Kessel B, Riley TL, Ragard LR, Williams CR, et al. The epidemiology of CA-125 in women without evidence of ovarian cancer in the prostate, lung, colorectal and ovarian cancer (PLCO) screening trial. Gynecol Oncol. 2008; 110: 383-389. PubMed: https://pubmed.ncbi.nlm.nih.gov/18586313/
  15. Kortekaas KE, Pelikan H. Hydrothorax, ascites and an abdominal mass: not always signs of a malignancy - three cases of Meigs' syndrome. Radiol Case. 2018; 12: 17-26. PubMed: https://pubmed.ncbi.nlm.nih.gov/29875983/
  16. Taniguchi Y, Nishikawa H, Maeda N, Terada Y. Breathlessness, pleural effusions, fibromas, and Meigs syndrome: look beyond the chest and don't delay! Lancet. 2020; 395: 32. PubMed:https://pubmed.ncbi.nlm.nih.gov/32061301/
  17. Sofoudis C, Kouiroukidou P, Louis K, Karasaridou K, Toutounas K, et al. Enormous ovarian fibroma with elevated Ca-125 associated with Meigs' syndrome. Presentation of a rare case. Eur J Gynaecol Oncol. 2016; 37: 142-143. PubMed: https://pubmed.ncbi.nlm.nih.gov/27048129/

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