ABSTRACT
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.
Subject(s)
Humans , Female , Adult , Meigs Syndrome/surgery , Meigs Syndrome/diagnosis , Case Reports , Weight Loss , Anorexia/complications , Women's Health , Pelvic Pain , Cough/complications , Dyspnea/complications , Fatigue/complications , Abdomen/physiopathologyABSTRACT
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.
Subject(s)
Adult , Male , Humans , Ovarian Neoplasms , Meigs Syndrome/diagnosis , Meigs Syndrome/physiopathology , Abdomen , Ascites/etiology , Abdominal Pain/etiology , Edema/etiology , Hydrothorax/etiology , Pleural Effusion , Meigs Syndrome/surgery , Treatment Outcome , VaginaABSTRACT
CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.
Subject(s)
CA-125 Antigen/blood , Meigs Syndrome/blood , Thecoma/blood , Aged , Female , Humans , Meigs Syndrome/surgery , Thecoma/surgeryABSTRACT
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
Subject(s)
Humans , Adult , Female , Postoperative Care , Obesity , General Surgery , Hydrothorax , Meigs Syndrome/surgery , Meigs Syndrome/complications , Meigs Syndrome/diagnosis , Venezuela , MedicineABSTRACT
The case of a patient with Meigs' syndrome, seen at Instituto Nacional de Perinatología, México City, is presented. The patient presented with: Hydrothorax, ascites and benign ovarian tumor (fibroma). The condition was managed by salpingo-oophorectomy; the patients was cured. Hydrothorax and ascites etiopathology, which is not clear at the present time, is mentioned.