Meigs syndrome:

Meigs syndrome:

• Meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor. The ovarian tumor in Meigs syndrome is a fibroma.
• Pseudo-Meigs syndrome consists of pleural effusion, ascites, and benign tumors of the ovary other than fibromas. These benign tumors include those of the fallopian tube or uterus and mature teratomas, struma ovarii, and ovarian leiomyomas.
• Pseudo-pseudo Meigs syndrome includes patients with systemic lupus erythematosus and enlarged ovaries.
• Tumor marker serum levels of CA125 can be elevated in Meigs syndrome, but the degree of elevation does not correlate with malignancy.
• Etiology of ascitic fluid: Pathophysiology of ascites in Meigs syndrome is speculative: considerations include irritation of the peritoneum, secretion form the mass itself, direct pressure on surrounding lymphatics or vessels, hormonal stimulation, and tumor torsion.
• Origin of pleural effusion: The etiology of pleural effusion is unclear. Current theory is that ascitic fluid is transferred via transdiaphragmatic lymphatic channels.
• Ascitic fluid and pleural fluid in Meigs syndrome can be either transudative or exudative.
• Ovarian tumors are more prevalent in upper socioeconomic groups. Ovarian fibroma is found in 2-5% of surgically removed ovarian tumors, and Meigs syndrome is observed in about 1%. Ascites is present in 10-15% of those with ovarian fibroma and hydrothorax in 1%, especially with larger lesions.
• Although Meigs syndrome mimics a malignant condition, it is a benign disease and has a very good prognosis if properly managed. Life expectancy after surgical removal of the tumor mirrors that of the general population.
• The incidence of ovarian tumor begins to increase in the third decade and increases progressively to peak in the seventh decade. Meigs syndrome in prepubertal girls with benign teratomas and cystadenomas has been reported.

References:

1. Jones OW, Surwit EA: Meigs syndrome and elevated CA 125. Obstet Gynecol 1989 Mar; 73(3 Pt 2): 520-1[Medline].
2. Lacson AG, Alrabeeah A, Gillis DA et al: Secondary massive ovarian edema with Meigs syndrome. Am J Clin Pathol 1989 May; 91(5): 597-603[Medline].
3. Lin JY, Angel C, Sickel JZ: Meigs syndrome with elevated serum CA 125. Obstet Gynecol 1992 Sep; 80(3 Pt 2): 563-6[Medline].
4. Meigs JV, Cass JW: Fibroma of the ovary with ascites and hydrothorax: with a report of seven cases. Am J Obstet Gynecol 1937; 33: 249-267.