Meigs' syndrome

Fibromyoma of the ovaries, ascites, pleural effusion. Distinguish from primary cranial dystonia (Meige's syndrome). Etiology: - associated with benign edematous ovarian fibromas > 10 cm in size Epidemiology: 1) associated with < 1% of ovarian fibromas 2) associated with 0.004% of ovarian tumors Pathology: - may result from torsion on stalk of large fibroma with backflow transudation of fluid back into the peritoneal cavity & eventually pleural cavity Clinical manifestations: 1) may be asymptomatic 2) pelvic mass 3) intermittent pelvic pain 4) abdominal pain 5) bloating 6) signs of ascites 7) signs of pleural effusion Laboratory: 1) complete blood count (rule out inflammation) 2) CA-125, hcG, AFP, CEA 3) chem-7 4) liver function tests Radiology: 1) pelvic ultrasound 2) chest X-ray Differential diagnosis: 1) ovarian or uterine malignancy 2) non-malignant disorder a) portal vein thrombosis b) obstruction of inferior vena cava c) obstruction of thoracic duct d) tuberculosis e) amyloidosis f) pancreatitis g) congestive heart failure h) connective tissue disease i) pancreatitis j) cirrhosis Management: 1) laparoscopic TAHBSO 2) prognosis: complete cure expected

References

Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995