Meigs' syndrome

Meigs' syndrome
Classification and external resources
ICD-10 D27
DiseasesDB 7943
eMedicine med/1422
MeSH D008539
Not to be confused with Meige syndrome

In medicine, Meigs' syndrome, also Meigs syndrome, is the triad of ascites, pleural effusion and benign ovarian tumor (fibroma, Brenner tumour and occasionally granulosa cell tumour).[1][2][3] It resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The etiologies of the ascites and pleural effusion are poorly understood.[1] Atypical Meigs' syndrome,characterized by a benign pelvic mass with right-sided pleural effusion but without ascites,can also occur. As in Meigs syndrome, pleural effusion resolves after removal of the pelvic mass.[4]

Differential diagnosis

It may mimic other conditions,[5]since it is tumor arising from ovaries, pathology of any organs present in the abdomen may show similar set of symptoms.Various gynecological disorders of uterus such as endometrial tumor, sarcoma, leiomyoma (pseudo-Meigs' syndrome), Fallopian tubules disorders such as Hydrosalpinx,granulomatous salpingitis, fallopian tube malignancy, ovarian disorders such as benign, serous, mucinous, endometrioid, clear cell, Brenner tumor, granulosa, stromal, dysgerminoma, fibroma, metastatic tumor.

Meigs' syndrome is characterized by the presence of a benign solid ovarian tumor associated with ascites and right hydrothorax that disappear after tumor removal. Non-gynecological disorders include: Ascites, Portal Vein Obstruction, IVC obstruction, Hypoproteinaemia, Thoracic duct obstruction, TB, Amyloidosis, Pancreatitis, Neoplasm, Ovarian hyperstimulation, Pleural effusion transudative, CHF, Malignancy metastatic tumors to the peritoneal surfaces, Collagen-vascular disease, Cirrhosis liver failure.

These entities must be clinically excluded. Clinical condition characterized by ovarian mass, ascites, and right-sided pleural effusion.Ovarian malignancy and the other causes (see “Differential Diagnosis”) of pelvic mass, ascites, and pleural effusion to be considered, History of early satiety, weight loss with increased abdominal girth, bloating, intermittent abdominal pain, dyspnea, nonproductive cough may help in differentiating potential local factor causing such symptoms.

Treatment

Treatment of Meigs' syndrome consists of thoracentesis and paracentesis to drain off the excess fluid (transudate), and unilateral salpingo-oophorectomy or wedge resection to correct the underlying etiology.

Eponym

Meigs' Syndrome is named for Joe Vincent Meigs.[6][7][8]

References

  1. 1.0 1.1 Meigs syndrome at eMedicine
  2. Morán-Mendoza A, Alvarado-Luna G, Calderillo-Ruiz G, Serrano-Olvera A, López-Graniel CM, Gallardo-Rincón D (2006). "Elevated CA125 level associated with Meigs' syndrome: case report and review of the literature". Int. J. Gynecol. Cancer 16 (Suppl 1): 315–318. doi:10.1111/j.1525-1438.2006.00228.x. PMID 16515612.
  3. Padubidri, Daftary. Shaw's Textbook Of Gynaecology, 15e. Elsevier India. p. 385. ISBN 9788131225486.
  4. http://emedicine.medscape.com/article/255450-overview
  5. Lanitis S, Sivakumar S, Behranwala K, Zacharakis E, Al Mufti R, Hadjiminas DJ (2009). "A case of Meigs syndrome mimicking metastatic breast carcinoma". World J Surg Oncol 7: 10. doi:10.1186/1477-7819-7-10. PMC 2633000. PMID 19161612.
  6. Meigs' syndrome at Who Named It?
  7. Lurie S (2000). "Meigs' syndrome: the history of the eponym". Eur. J. Obstet. Gynecol. Reprod. Biol. 92 (2): 199–204. doi:10.1016/S0301-2115(99)00289-4. PMID 10996681.
  8. Meigs JV (May 1954). "Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome". Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.