Características clínicas, diagnóstico e tratamento de mulher com síndrome de Meigs: relato de caso e revisão narrativa / Clinical characteristics, diagnosis and treatment of a woman with Meigs syndrome: case report and narrative review

O objetivo deste estudo é descrever o caso de mulher com síndrome de Meigs e apresentar a revisão narrativa sobre o tema. Paciente do sexo feminino, 30 anos, nulípara, encaminhada ao hospital por massa anexial e história prévia de drenagem de derrame pleural. Evoluiu com instabilidade hemodinâmica por derrame pleural hipertensivo à direita, sendo submetida a drenagem torácica, com citologia do líquido negativa. Após, foi submetida a laparotomia: realizada salpingo-ooforectomia esquerda. A congelação e a análise histopatológica diagnosticaram fibroma ovariano. A citologia ascítica foi negativa. CA-125 elevado, presença de derrames cavitários e exame de imagem suspeito podem mimetizar um cenário de neoplasia maligna de ovário em estágio avançado. Entretanto, na síndrome de Meigs clássica, o tratamento é cirúrgico, sendo o diagnóstico obtido por meio da análise histopatológica do tumor ovariano. O manejo da síndrome de Meigs clássica é cirúrgico e, após a remoção do tumor, o derrame pleural e a ascite desaparecem.

To describe a case of Meigs syndrome and present a narrative review of the condition. Female patient, 30 years old, nulliparous, referred to the hospital due to an adnexal mass and a previous drainage of pleural effusion. She developed hemodynamic instability due to a hypertensive right pleural effusion being submitted to chest drainage, with negative cytology of the fluid. She underwent laparotomy: Left salpingo-oophorectomy was performed and frozen section and histopathological analysis diagnosed an ovarian fibroma. Ascites cytology was negative. Elevated CA-125, presence of cavitary effusions, suspicious imaging exam can mimic a scenario of ovarian cancer at an advanced stage. However, in classical Meigs syndrome, treatment is surgical, and the diagnosis is obtained through histopathological analysis of the ovarian tumor. Classical Meigs syndrome' management is surgical. After tumor removal, pleural effusion and ascites resolve.

Clinical laboratory features of Meigs' syndrome: a retrospective study from 2009 to 2018 / 医学前沿

Meigs' syndrome (MS), a rare complication of benign ovarian tumors, is easily misdiagnosed as ovarian cancer (OC). We retrospectively reviewed the clinical laboratory data of patients diagnosed with MS from 2009 to 2018. Serum carbohydrate antigen 125 and HE4 levels were higher in the MS group than in the ovarian thecoma-fibroma (OTF) and healthy control groups (all P < 0.05). However, the serum HE4 levels were lower in the MS group than in the OC group (P < 0.001). A routine blood test showed that the absolute counts and percentages of lymphocytes were significantly lower in the MS group than in the OTF and control groups (all P < 0.05). However, these variables were higher in the MS group than in the OC group (both P < 0.05). The neutrophil-to-lymphocyte ratio (NLR) was also significantly lower, whereas the lymphocyte-to-monocyte ratio was higher in the MS group than in the OC group (both P < 0.05). The NLR, platelet-to-lymphocyte ratio, and systemic immune index were significantly higher in the MS group than in the OTF and control groups (all P < 0.05). The hypoxia-inducible factor-1 mRNA levels were also significantly higher, whereas the glucose transporter 1, lactate dehydrogenase, and enolase 1 mRNA levels were lower in peripheral CD4

Caso de pseudo-Meigs, signo guía de afección ginecológica subyacente / Case of Pseudo-Meigs, Guide Sign of Underlying Gynecological Condition

Introducción: El síndrome de Meigs consiste en la asociación de tumor benigno de ovario tipo fibroma con ascitis e hidrotórax, que se resuelven tras la extirpación del tumor. El síndrome de pseudo-Meigs secundario al leiomioma uterino es una entidad rara. Presentación de caso: Mujer de 68 años que presentó una historia de un mes con sensación de opresión torácica y disnea. La radiografía de tórax reveló derrame pleural derecho. En la tomografía axial computarizada de abdomen y región pelviana se aprecia ascitis y un gran mioma uterino subseroso. Se sometió a una histerectomía abdominal total con salpingo-ooforectomía bilateral. Conclusiones: La ascitis y el derrame pleural desaparecieron rápidamente en el postoperatorio. Tras 20 meses de seguimiento, no hay recidiva de la enfermedad(AU)

Introduction: Meigs syndrome consists of the association of a benign tumor of the ovary "fibroma type" with ascites and hydrothorax, which resolve after the tumor is removed. The pseudo-Meigs syndrome secondary to uterine leiomyoma is a rare entity. Case report: A 68-year-old woman refered having a month with a sensation of chest tightness and dyspnea. Chest X-ray revealed right pleural effusion. Computed axial tomography of the abdomen and pelvic region shows ascites and a large subserous uterine myoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Conclusions: Ascites and pleural effusion disappeared rapidly in the postoperative period. After 20 months of follow-up, there is no recurrence(AU)

Tumor estromal esclerosante de ovário associado à síndrome de Meigs e gestação: relato de caso / Sclerosing stromal tumor of the ovary associated with a Meigs' syndrome and pregnancy: a case report

O tumor estromal esclerosante de ovário é uma neoplasia benigna extremamente rara, mais frequente em mulheres jovens e sem sintomas específicos na maioria dos casos. Menos de 150 casos foram descritos, dos quais 8 diagnosticados durante a gestação. Neste relato, documentamos a associação entre tumor estromal esclerosante de ovário, síndrome de Meigs e elevação dos níveis de CA-125 em gravidez a termo.

The sclerosing stromal tumor of the ovary is an extremely rare benign tumor more common in young women and without specific symptoms in most cases. Less than 150 cases have been described, of which 8 were diagnosed during pregnancy. In this report, we describe the association between sclerosing stromal tumor of the ovary, Meigs' syndrome and elevated levels of CA-125 in term pregnancy.

Síndrome de Meigs: caso clínico y revisión de la literatura / Meigs syndrome: a case presentation and revision of the literature

El Síndrome de Meigs se define como la existencia de ascitis e hidrotórax en asociación con una tumoración ovárica benigna. Es una entidad clínica poco frecuente que se asocia sólo muy ocasionalmente con los de fibromas del ovario. Se presenta el caso de una paciente de 22 años con una historia de dolor abdominal de 3 días de evolución. El estudio clínico y ultrasonográfico revela presencia de masa hipogástrica compleja, ascitis severa, asociada a derrame pleural. El estudio de laboratorio muestra una elevación de CA 125. Es intervenida quirúrgicamente, realizándose extirpación tumoral y remoción de líquido ascítico (13 litros). Biopsia informa fibroma edematoso del ovario izquierdo de 17x14x cm. Evoluciona favorablemente con remisión de la ascitis y del derrame pleural.

Síndrome de Meig / Meig syndrome

El síndrome de meig se define como un tumor pélvico con ascitis e hidrotórax, que se resuelve con la extracción del tumor. Este caso concierne a una mujer de 29 años que acudió al departamento de emergencia con dificultad para respirar. Se palpaba una tumoración abdominopélvica, móvil, el examen pélvico bimanual. La evaluación mediante tomografía axial computarizada abdominopélvica demostró ascitis y una tumoración sólida que se extendía desde la pelvis hasta el riñón derecho. Al practicarse la laparotomía, el diagnóstico fue de fibroma de ovario. El derrame plural se resolvió completamente en el postoperatorio. Se discute la importancia clínica de este síndrome

Syndrome de Demons-Meigs à propos d'un cas

Le syndrome de Demons-Meigs est une tumeur benigne de l'ovaire avec épanchements séreux (ascite; épanchement pleural) recidivants mais resorbable apres exérèse. Il est rare. Sa physiopathologie reste obscure. Dans le cas présent; il s'agit d'un cystadénome mucineux géant de 30 kgs