Pelvic mass, ascites, hydrothorax: a malignant or benign condition? Meigs syndrome with high levels of CA 125.
| Autor: | Stabile G; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy., Zinicola G; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Romano F; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy., Laganà AS; Department of Obstetrics and Gynecology, 'Filippo Del Ponte' Hospital, University of Insubria, Varese, Italy., Pozzolo CD; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Ricci G; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Przeglad menopauzalny = Menopause review [Prz Menopauzalny] 2021 Jun; Vol. 20 (2), pp. 103-107. Date of Electronic Publication: 2021 May 25. |
| DOI: | 10.5114/pm.2021.106100 |
| Abstrakt: | Introduction: Abdominal-pelvic mass, ascites and pleural effusion are suggestive of malignant metastatic ovarian cancer. This triad is also present in a rare benign condition called Meigs syndrome. Rarely this condition is associated with an increased CA 125 level. Case Report: A 62-year-old woman with a history of abdominal pain underwent an ultrasound (US) examination and a chest X-ray. The imaging revealed the presence of a large pelvic mass and ascites with a monolateral pleural effusion and a high level of the tumor marker CA 125. The patient underwent a total abdominal hysterectomy, salpingoophorectomy, removal of the pelvic mass, pelvic lymphadenectomy and peritoneal biopsies. The histology showed an ovarian fibrothecoma. Discussion: The US analysis according to international ovarian tumor analysis simple rules revealed "inconclusive results"; the logistic regression model LR2 and Adnex suggested a high risk of malignancy. The presence of ascites and the size of the lesion associated with a high level of CA 125 affected the correct assessment of the risk of malignancy, exposing the patient to overtreatment. Conclusions: Meigs syndrome is characterized by the resolution of symptoms after surgical removal of the pelvic mass. However, it mimics the clinical picture of a malignant metastatic ovarian cancer. Clinicians have to exclude ovarian cancer and recognize the syndrome to reduce inappropriate procedures. Competing Interests: The authors report no conflict of interest. (Copyright: © 2021 Termedia Sp. z o. o.) |
| Databáze: | MEDLINE |
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