In 1937, meigs described a syndrome of ovarian fibromas with ascites and hydrothorax that quickly resolved on removal of the fibroma. Meigs syndrome symptoms diagnosis treatment prognosis. Meigs syndrome is a rare syndrome defined as the triad of benign solid ovarian tumors, ascites, and pleural effusion. Meigs syndrome in an elderly woman with short of breath. Meigs syndrome article about meigs syndrome by the free. Ovarian fibromas constitute the majority of the benign tumors seen in meigs syndrome. Meigs syndrome, however, is a diagnosis of exclusion, only after ovarian carcinoma is ruled out. In the vast majority 8090% of cases, the primary tumor is an ovarian fibroma. Nonclassic meigs syndrome and demons meigs syndrome. Meigs syndrome is characteristically associated with ovarian fibroma whereas pseudo meigs syndrome is associated with any ovarian or pelvic tumors, other than ovarian fibroma. By 1932 five more cases were added and meigs and cass in their report in 1937 brought this syndrome to the attention of the medical world.
Pleural effusion in meigs syndrometransudate or exudate. Fibromas are rarely associated with meigs syndrome ie, ovarian fibroma, ascites, pleural effusion. Ovarian fibroma represents 2 to 5% of ovarian tumor and out of this only 1 to 2% of cases present as meigs syndrome. It has been described mostly in patients without a known prior diagnosis of sle and often presents with painless, gradual onset, mild to moderate ascites. Breathlessness, pleural effusions, fibromas, and meigs. However in literature 28 cases meigs syndrome benign ovarian tumor, ascites and right pleural effusion with raised ca 125 have been reported. The benign tumors in meigs syndrome are usually fibromas or fibrothecomas and constitute 4% of all ovarian neoplasms. Meigs syndrome must be recognized in a timely manner and promptly treated by performing a complete resection of the pelvic mass. It is actually a combination of two forms of dystonia, blepharospasm and oromandibular dystonia omd. Meigs syndrome is a condition in which certain benign tumors of the ovary are associated with ascites and hydrothorax, resembling a malignant tumor with metastases.
Meige syndrome genetic and rare diseases information. Meigs syndrome presenting with axillary vein thrombosis and lymphadenopathy. Meigs syndrome is defined as the coexistence of benign ovarian fibroma or. The association of pseudo meigs syndrome with struma ovarii is a rare condition.
Pseudo or not, appropriate treatment of a patient with a pleural effusion can only be given once the diagnosis. Meigs syndrome is the triad of ovarian tumor chapter 205, ascites, and pleural effusion. When omd is combined with blepharospasm, it may be referred to as meiges syndrome named after henri meige, the french neurologist who first described the symptoms. A benign ovarian tumour a fibroma, or fibromalike tumour. Pdf we report the case of puerperal ascites, associated with elevated ca125. Meigs syndrome is a strange clinical entity that is also considered to be an uncommon complication of fibroma of the female genital tract. In medicine, meigs syndrome, also meigs syndrome or demonsmeigs syndrome, is the triad of ascites, pleural effusion, and benign ovarian tumor ovarian fibroma, fibrothecoma, brenner tumour, and occasionally granulosa cell tumour. Meigs syndrome an accumulation of fluid in the abdomen or in the space between the lungs and the chest wall pleural effusion associated with a fibroma or other tumour of an ovary.
The syndrome appears in approximately 1% of ovarian fibromas. Meigs syndrome is named after joe vincent meigs, an american obstetrician and gynaecologist 18921963, who reported a case series in 1937 and subsequently described the syndrome. Meigs syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. In medicine, meigs syndrome, also meigs syndrome or demons meigs syndrome, is the triad of ascites, pleural effusion, and benign ovarian tumor ovarian fibroma, fibrothecoma, brenner tumour, and occasionally granulosa cell tumour. A final diagnosis of atypical pseudomeigs syndrome was performed, being computed. The torsion of the large cystic tumor produced the acute symptoms which forced the patient to seek relief. The condition is important out of proportion to its incidence because it is easily curable if recognized. Medical care of patient with meigs syndrome involves paracentesis and thoracentesis for ascites and pleural effusion respectively. Markedly elevated levels of vascular endothelial growth factor, fibroblast growth factor, and interleukin 6 in meigs syndrome. The untreated meigs syndrome is fatal, and the common mechanism of death is lung collapse due to the large amount of pleural effusion. Meigs syndrome not converted to malignant and if treated promptly and its prognosis is excellent meigs syndrome is the triad of benign ovarian tumor, ascites and pleural effusion1. The authors present a case of meigs syndrome with an ovarian fibroma. Dec, 2016 meigs syndrome is named after joe vincent meigs, an american obstetrician and gynaecologist 18921963, who reported a case series in 1937 and subsequently described the syndrome. Struma ovarii associated with pseudomeigs syndrome.
The authors report a case of meigs syndrome with elevated ca 125 level. Uterine leiomyomas rarely cause pseudomeigs syndrome. The condition is being treated with botulinum toxin. A 65yearold brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. Pdf pleural effusion in meigs syndrometransudate or. The specific symptoms, severity and progression of meige syndrome can vary from person to person. In september, 2003, a 33yearold woman was referred to our medical facility. It most often affects middleaged people and usually is characterized by a combination of blepharospasm and oromandibular dystonia.
Meigs syndrome definition of meigs syndrome by medical. Ascites, pleural effusion, pelvic mass, meigs, ovarian malignancy. A 48yearold perimenopausal woman presented with a long history of 810 years of. It is also known as brueghels syndrome and oral facial dystonia. It is often seen concomitantly with uterine leiomyoma suggesting an identical hormonal stimulation and rarely associated with hirsutism or infertility. Meigs syndrome includes findings of an adnexal mass, ascites, and pleural effusions. Printer kd 1967 pseudomeigs syndrome associated with a preg. The effusion, which is usually large and on the right side, is formed when fluid moves from the abdomen to the pleural space through diaphragmatic defects. This condition was further subclassified into 2 categories.
Meigs syndrome, however, is a diagnosis of exclusion, only after. Ovarian fibroma in young women with infertility mimicking. This is a case report of meigs syndrome with elevated ca 125 level. Meigs separated his definition into true meigs syndrome, which he preferred to call demons meigs syndrome and pseudo meigs syndrome distinguished by different tumor. Meige syndrome genetic and rare diseases information center. Mar 24, 2016 meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor. Pseudomeigs syndrome with degenerative uterine leiomyoma in. Meigs syndrome article about meigs syndrome by the. Ovarian ovarian fibromas form the most of the benign tumors seen in meigs syndrome. Elevated ca125 level associated with meigs syndrome. Mendoza a, luna ga, ruiz gc, olvera as, lopez graniel cm, rincon dg. Pseudopseudo meigs syndrome ppms is a newly emerging manifestation of systemic lupus erythematosus sle, characterized by the presence of pleural effusion, ascites and raised ca125 levels. Not to be confused with meige syndrome or meige disease.
View the article pdf and any associated supplements and. This is known as meigs syndrome, a name first suggested by rhoads and terrel in 1937. Peritoneal and pleural fluids of the patients originally with ms were transudates. May 01, 2015 meigs syndrome must be recognized in a timely manner and promptly treated by performing a complete resection of the pelvic mass. Meigs syndrome is the triad of benign ovarian tumor, ascites and pleural effusion1. Ovarian sex cordstromal ovarian sex cordstromal imaging of pleural effusions in adults view in chinese. Apr 29, 2019 pseudopseudo meigs syndrome ppms is a newly emerging manifestation of systemic lupus erythematosus sle, characterized by the presence of pleural effusion, ascites and raised ca125 levels. The meigs syndrome ms described in 1937 by meigs and cass was characterized by benign ovarian fibroma, ascites and hydrothorax that resolve after the tumor removal. Blepharospasm is characterized by abnormal, forced blinking and spasms of the eyelids. Ovarian fibroma can be bilateral in 4%8% of patients and multiple in 10% of cases, especially in gorlin syndrome, or associated with pleural effusion and ascites in meigs syndrome.
Whereas, pseudo meigs syndrome is the coexistence of hydrothorax, ascites, and other ovarianor pelvic tumors. Meigs syndrome represents a triad of pleural effusion, ascites, and an ovarian tumor, which is usually benign, occurring together. I want to welcome everyone to meigs academic magnet school for another incredible year of learning. Although meigs syndrome may appear as an advanced malignant tumor, the prognosis is ex cellent if it is early diagnosed, since the early recognition can prevent the death of the patient. We believe that this episode was incidental to a preexisting meigs syndrome. Meigs syndrome is also known as meigs syndrome or demons meigs syndrome. Meigs syndrome an accumulation of fluid in the abdomen ascites or in the space between the lungs and the chest wall pleural effusion associated with a fibroma or other tumour of an ovary. Meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor. Peritoneal and pleural fluids of the patients originally with ms were transudates 1. History in 1934, salmon described the association of. Meigs syndrome accounts for approximately 1% of all ovarian tumors. We describe here 2 patients with meigs syndrome and 2 patients with pseudo meigs syndrome.
Physical examination showed dullness in thoracic percussion bilaterally and abdominal distension. Ovarian fibroma with meigs syndrome associated with. The 20192020 school year will be a year of setting and reaching attainable goals through hard work and determination. Dec 11, 2015 pseudomeigs syndrome refers to ascites and pleural fluid secondary to any other pelvic or abdominal tumors not included in definition of demons meigs syndrome. Meigs syndrome describes the occurrence of a solid benign ovarian tumor, usually a fibroma, along with the presence of ascites and pleural effusions. The term nonclassic meigs syndrome was applied for patients with ascites and pleural effusion associated with benign ovarian, fallopian tube, or broad ligament tumors other than those included in the definition of classic meigs syndrome table table1. They focus on the evaluation of pleural fluid in the setting of an ovarian mass and then briefly discuss the imaging of ovarian. Treatment of meigs syndrome consists of thoracentesis and paracentesis to drain off the excess fluid exudate, and unilateral.
As far as we can discover, only two cases of meigs syndrome have been observed at michael reese hospital in many years. She initially presented to her personal physician in july, 2003, with a 2month history of progressive dyspnoea, abdominal distension, and pedal oedema. Thus far only 10 to 11 cases have been reported in the english literature. Cullingworth in 1879 published an account of a patient, who had pelvic masses, ascites, and hydrothorax.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Consultant gynaecologist and obstetrician british military hospital, munster. The majority of cases usually resolve after surgical resection of the ovarian mass. Meigs syndrome is a medical condition with a triad of symptoms including benign ovarian tumor, ascites and pleural effusion. Although meigs syndrome is regarded as a welldefined entity. Meigs syndrome reveals that less than 2% of people turn into malignant2. Meigs syndrome usually occurs in postmenopausal women and resolves following removal of the. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. Conclusion the ovarian benign tumor with meigs syndrome may mimic malignancy. Kd printerpseudomeigs syndrome associated with a pregnancy near term. Meigs syndrome with malignant or benign ovarian tumoursother than fibromas or fibromalike tumoursor uterine or fallopian tumours is referred to as pseudo meigs syndrome. Meigs syndrome, however, is a diagnosis of exclusion only.
Hydrothorax and ascites symptoms in 4 patients are of outstanding performance characteristics of meigs syndrome and pseudo meigs syndrome. Meigs syndrome is a rare condition, defined as the coexistence of benign ovarian fibroma, pleural effusion and ascites. The more frequently observed type of ovarian tumor is the fibroma. Aggressive treatment, including r0 resection, for this disease if. Meigs proposed limiting the diagnosis of meigs syndrome to benign and solid ovarian tumours with ascites and pleural effusion, and with the condition that removal of the tumour cures the patient without recurrence. While, pseudo meigs syndrome is characterized by the coexistence of pleural effusion, ascites and other ovarian or pelvic tumors.
Feb 17, 2015 meige syndrome is a rare, neurological condition characterized by blepharospasm abnormal movement of the eyelids. When benign ovarian fibroma is associated with ascites andor pleural effusion it is termed meigs syndrome. Longterm survival in pseudomeigs syndrome caused by ovarian. Pdf herein, a rare case of ovarian granulosa cell tumor, presenting as meigs syndrome, with elevated carbohydrate antigen 125 ca125. It has been described mostly in patients without a known prior diagnosis of sle and often presents with painless, gradual onset, mild to moderate. We recommend oophorectomy for diagnosis and cure for women with we recommend oophorectomy for diagnosis and cure for women with. Pseudo meigs is a variant not possessing the original tumor cell types described by meigs. Pdf pleural effusion in meigs syndrometransudate or exudate.