J Menopausal Med.  2015 Apr;21(1):56-59. 10.6118/jmm.2015.21.1.56.

Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report

• Park JW
• Bae JW

• KMID: 2201023
• DOI: http://doi.org/10.6118/jmm.2015.21.1.56

Abstract

Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated cancer antigen 125 (CA-125) in Meigs' syndrome is an unusual clinical condition reported in few cases. We report here on a 61-year-old woman who presented with dyspnea; in imaging assessment, a heterogeneous pelvic mass measuring 12 x 11 cm with ascitic fluid was reported. Pleural effusion was detected on Chest X-ray. Aspiration of pleural fluid showed no evidence of malignancy. CA-125 level was 347 IU/mL. The patient underwent laparotomy during which a mass measuring 12 x 11 cm was detected in her left adnexa. Histology showed ovarian thecoma. The mass was resected, and, after that, the symptoms disappeared and CA-125 level reached 19 IU/mL. The patient had experienced no problem after 12 months of follow up. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA-125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.

Keyword

CA-125; Meigs syndrome; Pleural effusion

MeSH Terms

Ascites
Ascitic Fluid
Diagnosis, Differential
Dyspnea
Female
Follow-Up Studies
Humans
Laparotomy
Meigs Syndrome*
Middle Aged
Pleural Effusion
Thecoma
Thorax

Figure

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  Fig. 1 A chest X-ray revealed the presence of a massive right sided pleural effusion.

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  Fig. 2 Abdominopelvic computed tomography scan revealed a solid heterogeneous mass in pelvic midline with ascites.

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  Fig. 3 The tumor cells have bland, oval to spindle shaped nuclei and abundant, pale vacuolated cytoplasm. Individual tumor cells are invested by thin reticulin fibers (H&E × 400).

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