Meigs Syndrome

What is Meigs Syndrome?

This is a syndrome with the trio of ascites (fluid in peritoneal cavity), pleural effusion (excess fluid in the pleura) and ovarian tumor that is benign. Its resolution is only when there is the resection of the tumor. For unknown reasons, the pleural effusion is characteristically right sided.


Symptoms

The symptoms and signs of Meigs syndrome consist of:

  • Shortness of breath
  • Fatigue
  • Increased abdominal size
  • Weight loss
  • Amenorrhea for premenopausal women
  • Bloating
  • Dullness of percussion of lungs
  • Tachycardia
  • Present of ascites
  • Present of pelvic mass
  • Abdominal examination may feel the mass

The differential diagnosis of Meigs syndrome includes:

  • Renal failure
  • Liver failure – cirrhosis
  • Congestive heart failure
  • Metastatic tumors
  • Tuberculosis
  • Malnutrition
  • Ovarian cancer
  • Lung cancer, non-small cell

How to diagnose Meigs syndrome:

  • Physical exam
  • Patient history
  • Imaging studies
  • Lab test
  • Histologic findings

Causes

Cause of this syndrome is a fibrous growth in a woman’s ovary which causes abnormal levels of sex hormone production.

Treatment

The medical treatment of individuals with Meigs syndrome is mostly intentional to offer relief that symptomatic of pleural effusion and ascites by means of therapeutic paracentesis which is a needle drainage procedure for the peritoneal cavity, and thoracentesis which is an invasive procedure to remove fluid or air from the pleural space.

Complications

The major complications of Meigs syndrome is Infertility.

Surgery

An investigative laparotomy with full surgical access is the choice for treatment for this syndrome. Execute a frozen slice of the ovarian mass during an exploratory laparotomy. If the section is constant with a tumor is benign, conservative surgery – salpingo-oophoredctomy or oophorectomy – is applicable.

Results of lymphatic node biopsies and pelvic washings and omentum are negative for malignancy if these processes are performed during surgery.

  • In those women of reproductive age, execute a unilateral salpingo-oophorectomy.
  • In women postmenopausal, choices include salpingo-oophorectomy that is bilateral with hysterectomy that is total and or occasionally bilateral or unilateral salpingo-oophorectomy.
  • In girls who are prepubertal, choices include unilateral salpingo-oophorectomy or wedge resection of the ovary

The rate of cure after either type of surgery is high and recurrence is very rare.

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