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'''For patient information, please click [[Meigs syndrome (patient information)|here]]''' 
                                                               
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==Overview==
==Overview==


'''Meigs syndrome''' '''(also known as "Demons Meigs syndrome")''' is defined as the triad of ascites, pleural effusion, and benign ovarian tumor (fibroma, Brenner tumour and occasionally granulosa cell tumour). Meigs syndrome was first discovered by Otto von Spiegelberg, a German gynecologist, in 1866.<ref name="pmid20896800">{{cite journal |vauthors=Tait L |title=On the occurrence of Pleural Effusion in association with Disease of the Abdomen |journal=Med Chir Trans |volume=75 |issue= |pages=109–18 |year=1892 |pmid=20896800 |pmc=2036288 |doi= |url=}}</ref>
'''Meigs syndrome''' '''(also known as "Meigs-Cass syndrome")''' is defined as the triad of [[ascites]], [[pleural effusion]], and [[Ovarian tumor|benign ovarian tumor]]. Meigs syndrome was first discovered by Otto von Spiegelberg, a German gynecologist, in 1866. There is no classification system established for Meigs syndrome. Other variants of Meigs syndrome include pseudo-meigs syndrome, and atypical Meigs' syndrome. Meigs syndrome may be caused by either [[ovarian fibroma]], [[Brenner tumor]], [[Thecoma|ovarian thecoma]], or [[Granulosa cell tumour|granulosa cell tumor]]. The pathogenesis of Meigs syndrome is characterized by a transudative process. The prevalence of benign ovarian tumors is approximately 2-10%, and only 1-2% develop Meigs syndrome. Meigs syndrome is more commonly observed among postmenopausal women. The median age at diagnosis is approximately 50 years. The majority of patients with Meigs syndrome are asymptomatic.  Early clinical features include [[bloating]], [[fatigue]], and [[shortness of breath]]. Computed tomography is the imaging modality of choice for Meigs syndrome. On conventional radiography, Meigs syndrome is characterized by blunting of the costophrenic angle or fluid within the horizontal or oblique fissures (250-600 ml of fluid is required before the pleural effusion becomes evident). Surgery is the mainstay of therapy for Meigs syndrome. [[Laparotomy|Exploratory laparotomy]] with [[Cancer staging|surgical staging]] is the most common approach to the treatment of Meigs syndrome. Once diagnosed and successfully treated, patients with Meigs syndrome are followed-up every 6 months. Follow-up testing includes; serum cancer antigen 125, ultrasound, and basic metabolic profile.


==Historical Perspective==
==Historical Perspective==
Line 16: Line 19:
==Classification==
==Classification==
*There is no classification system established for Meigs syndrome.<ref name="pmid25662723">{{cite journal |vauthors=Gil A, Roque A, Alemán C |title=[Meigs' syndrome] |language=Spanish; Castilian |journal=Med Clin (Barc) |volume=145 |issue=2 |pages=95 |year=2015 |pmid=25662723 |doi=10.1016/j.medcli.2014.12.007 |url=}}</ref>
*There is no classification system established for Meigs syndrome.<ref name="pmid25662723">{{cite journal |vauthors=Gil A, Roque A, Alemán C |title=[Meigs' syndrome] |language=Spanish; Castilian |journal=Med Clin (Barc) |volume=145 |issue=2 |pages=95 |year=2015 |pmid=25662723 |doi=10.1016/j.medcli.2014.12.007 |url=}}</ref>
*Other variants of Meigs syndrome may include pseudo-meigs syndrome, and atypical Meigs' syndrome.
*Other variants of Meigs syndrome include pseudo-meigs syndrome, and atypical Meigs' syndrome.


==Pathophysiology==
==Pathophysiology==
*The pathogenesis of Meigs syndrome is characterized by the formation of the peritoneal and pleural effusion to the filtration of interstitial fluid in the peritoneum through the tumor capsule, and the diffusion to the pleural space.
*The pathogenesis of Meigs syndrome is characterized by a transudative process.<ref name="ppp">Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting meigs syndrome. J Bronchology Interv Pulmonol. 2013 Jan. 20(1):48-51.</ref>
*The [gene name] gene/Mutation in [gene name] has been associated with the development of Meigs syndrome, involving the [molecular pathway] pathway.
*The transudative process consists in the formation of peritoneal and pleural effusion to the filtration of interstitial fluid in the peritoneum through the tumor capsule, and the diffusion to the pleural space.<ref name="pmid8351065">{{cite journal |vauthors=Santopaolo O, Rotondo A, Alfè M, Canciello P, Rito Marcone G, Cusati B |title=[Meigs syndrome with bilateral hydrothorax] |language=Italian |journal=Minerva Ginecol |volume=45 |issue=5 |pages=263–6 |year=1993 |pmid=8351065 |doi= |url=}}</ref>
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of Meigs syndrome.
*There are no genes associated with the development of Meigs syndrome.
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of Meigs syndrome.
*On gross pathology, marked ovarian enlargement, watery cut surface, and no necrosis are characteristic findings of Meigs syndrome.<ref name="pathologyoutlines">Ovary - nontumor. Pathology Outlines. http://www.pathologyoutlines.com/topic/ovarymassiveedema.html Accessed on March 29,2016</ref>
*On microscopic histopathological analysis, variable stromal luteinization, marked edema of stroma surrounding follicles, and stroma around vessels are characteristic findings of Meigs syndrome.<ref name="pathologyoutlines">Ovary - nontumor. Pathology Outlines. http://www.pathologyoutlines.com/topic/ovarymassiveedema.html Accessed on March 29,2016</ref>
 
==Causes==
==Causes==
* Meigs syndrome may be caused by either [cause1], [cause2], or [cause3].
* Meigs syndrome may be caused by either ovarian fibroma, Brenner tumor, ovarian thecoma, or granulosa cell tumor.<ref name="wiki">Meigs syndrome. Wikipedia. https://en.wikipedia.org/wiki/Meigs'_syndrome Accessed on March 29, 2016</ref><ref name="radio">Meigs syndrome. Radiopedia. http://radiopaedia.org/articles/meigs-syndrome Accessed on March 29, 2016</ref>
* Meigs syndrome is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
* In general, Meigs syndrome may be caused by any benign ovarian tumor.
* There are no established causes for Meigs syndrome.
 
==Differentiating Meigs syndrome from other Diseases==
==Differentiating Meigs syndrome from other Diseases==
*Meigs syndrome must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
*Meigs syndrome must be differentiated from other diseases that cause bloating, fatigue, and shortness of breath such as:<ref name="pmid23328144">{{cite journal |vauthors=Riker D, Goba D |title=Ovarian mass, pleural effusion, and ascites: revisiting Meigs syndrome |journal=J Bronchology Interv Pulmonol |volume=20 |issue=1 |pages=48–51 |year=2013 |pmid=23328144 |doi=10.1097/LBR.0b013e31827ccb35 |url=}}</ref>
:*[Differential dx1]
:*[[Ovarian cancer]]
:*[Differential dx2]
:*[[Cirrhosis]]  
:*[Differential dx3]
:*[[Colon cancer]]
:*[[Tuberculosis]]
:*Milroy's disease
 
==Epidemiology and Demographics==
==Epidemiology and Demographics==
* The prevalence of Meigs syndrome is approximately [number or range] per 100,000 individuals worldwide.
 
* In [year], the incidence of Meigs syndrome was estimated to be [number or range] cases per 100,000 individuals in [location].
===Prevalence===
* The prevalence of Meigs syndrome is unknown.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
*The prevalence of benign ovarian tumors is approximately 2-10%, and only 1-2% develop Meigs syndrome.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
   
   
===Age===
===Age===
*Patients of all age groups may develop Meigs syndrome.
*Meigs syndrome is more commonly observed among postmenopausal women.
*The median age at diagnosis is approximately 50 years.  
*Meigs syndrome is more commonly observed among patients aged [age range] years old.
*Meigs syndrome is more commonly observed among [elderly patients/young patients/children].
   
   
===Gender===
===Gender===
*Meigs syndrome affects men and women equally.
*Meigs syndrome affects exclusively females.  
*[Gender 1] are more commonly affected with Meigs syndrome than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
   
   
===Race===
===Race===
*There is no racial predilection for Meigs syndrome.
*There is no racial predilection for Meigs syndrome.
*Meigs syndrome usually affects females with higher socioeconomic status.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
*Meigs syndrome usually affects individuals of the [race 1] race.
 
*[Race 2] individuals are less likely to develop Meigs syndrome.
==Risk Factors==
==Risk Factors==
*Common risk factors in the development of Meigs syndrome are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of Meigs syndrome are enlarged adnexal mass ( > 5cm), co-existing pleural effusion, and family history of any form of cancer.<ref name="pmid15738016">{{cite journal |vauthors=Simpkins F, Zahurak M, Armstrong D, Grumbine F, Bristow R |title=Ovarian malignancy in breast cancer patients with an adnexal mass |journal=Obstet Gynecol |volume=105 |issue=3 |pages=507–13 |year=2005 |pmid=15738016 |doi=10.1097/01.AOG.0000154162.51442.14 |url=}}</ref>
 
== Natural History, Complications and Prognosis==
== Natural History, Complications and Prognosis==
*The majority of patients with Meigs syndrome remain asymptomatic for [duration/years].  
*The majority of patients with Meigs syndrome are asymptomatic.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref> 
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*Early clinical features include bloating, fatigue, and shortness of breath.
*If left untreated, [#%] of patients with Meigs syndrome may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, the majority of patients with Meigs syndrome may progress to develop [[respiratory failure]], [[ovarian torsion]], and [[hypoproteinemia]].  
*Common complications of Meigs syndrome include [complication 1], [complication 2], and [complication 3].
*Common complications of Meigs syndrome include portal vein obstruction, [[inferior vena cava obstruction]], and [[thoracic duct]] obstruction.  
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with Meigs syndrome is approximately [#%].
*Prognosis is generally good, and the 5 survival rate of patients with Meigs syndrome is approximately 100%.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
 
== Diagnosis ==
== Diagnosis ==
===Diagnostic Criteria===
===Diagnostic Criteria===
*The diagnosis of Meigs syndrome is made when at least [number] of the following [number] diagnostic criteria are met:
*The diagnosis of Meigs syndrome is made when the following 3 diagnostic criteria are met:
:*[criterion 1]
:*Ascities
:*[criterion 2]
:*Pleural effusion or [[hydrothorax]]
:*[criterion 3]
:*Benign ovarian tumor
:*[criterion 4]
   
   
=== Symptoms ===
=== Symptoms ===
*Meigs syndrome is usually asymptomatic.
*Meigs syndrome is usually [[asymptomatic]].
*Symptoms of Meigs syndrome may include the following:
*Symptoms of Meigs syndrome may include the following:
:*[symptom 1]
:*[[Bloating]]
:*[symptom 2]
:*[[Fatigue]]
:*[symptom 3]
:*[[Weight-loss]]
:*[symptom 4]
:*[[Shortness of breath]]  
:*[symptom 5]
:*[[Cough]]
:*[symptom 6]
:*[[Menstrual disorder|Menstrual irregularity]]
   
   
=== Physical Examination ===
=== Physical Examination ===
*Patients with Meigs syndrome usually appear [general appearance].
*Patients with Meigs syndrome are usually well-appearing.
*Physical examination may be remarkable for:
*Physical examination may be remarkable for:
:*[finding 1]
:*Increased abdominal perimeter
:*[finding 2]
:*Decreased/absent breath sounds
:*[finding 3]
:*Reduced [[chest expansion]]
:*[finding 4]
:*Rapid rate of breathing
:*[finding 5]
 
:*[finding 6]
=== Laboratory Findings ===
=== Laboratory Findings ===
*There are no specific laboratory findings associated with Meigs syndrome.
*There are no specific laboratory findings associated with Meigs syndrome.
 
*In some cases, unspecific laboratory findings may include abnormal [[CA-125 test|serum cancer antigen 125]] test and abnormal prothrombin time.
*A  [positive/negative] [test name] is diagnostic of Meigs syndrome.
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of Meigs syndrome.
*Other laboratory findings consistent with the diagnosis of Meigs syndrome include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
   
   
===Imaging Findings===
===Imaging Findings===
*There are no [imaging study] findings associated with Meigs syndrome.
*Computed tomography is the imaging modality of choice for Meigs syndrome.
*On conventional radiography, Meigs syndrome is characterized by blunting of the costophrenic angle or fluid within the horizontal or oblique fissures (250-600 ml of fluid is required before the pleural effusion becomes evident)
*[Imaging study 1] is the imaging modality of choice for Meigs syndrome.
*On computed tomography, findings include: presence of ascites, and characterization of ovarian mass.  
*On [imaging study 1], Meigs syndrome is characterized by [finding 1], [finding 2], and [finding 3].
*Ultrasound may demonstrate and confirm the presence of ovarian mass and ascities.  
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
=== Other Diagnostic Studies ===
*Meigs syndrome may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
   
   
===Other Diagnostic Studies ===
*Meigs syndrome may also be diagnosed using thoracentesis or paracentesis.<ref name="laparoscopy">Meigs' Syndrome: a case presentation and revision of the literature. http://www.obgyn.net/laparoscopy-and-hysteroscopy/meigs-syndrome-case-presentation-and-revision-literature#sthash.NQ3ZxKLh.dpuf Accessed on March 29, 2016 </ref>
*Findings on paracentesis include transudative ascitic fluid, and presence of reactive mesothelial cells.
*Findings on thoracentesis include transudative pleural fluid, and negative for malignant cells.
== Treatment ==
== Treatment ==
=== Medical Therapy ===
=== Medical Therapy ===
*There is no treatment for Meigs syndrome; the mainstay of therapy is supportive care.
*There is no medical treatment for Meigs syndrome.  
*The mainstay of therapy for Meigs syndrome is [medical therapy 1] and [medical therapy 2].
*[Medical therapy 1] acts by [mechanism of action1].
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
   
   
=== Surgery ===
=== Surgery ===
*Surgery is the mainstay of therapy for Meigs syndrome.
*Surgery is the mainstay of therapy for Meigs syndrome.
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of Meigs syndrome.
*Exploratory laparotomy with surgical staging is the most common approach to the treatment of Meigs syndrome.
*[Surgical procedure] can only be performed for patients with [disease stage] Meigs syndrome.
*Meigs syndrome is a benign condition and the ascites and pleural effusion resolves after resection of the primary pelvic tumor.
 
=== Prevention ===
=== Prevention ===
*There are no primary preventive measures available for Meigs syndrome.
*There are no primary preventive measures available for Meigs syndrome.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
*Once diagnosed and successfully treated, patients with Meigs syndrome are followed-up every 6 months.  
*Effective measures for the primary prevention of Meigs syndrome include [measure1], [measure2], and [measure3].
*Follow-up testing includes; serum cancer antigen 125, ultrasound, and basic metabolic profile.<ref name="pmid22369402">{{cite journal |vauthors=Annaiah TK, Reynolds SF, Lopez C |title=Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases? |journal=J Obstet Gynaecol |volume=32 |issue=3 |pages=267–70 |year=2012 |pmid=22369402 |doi=10.3109/01443615.2011.626089 |url=}}</ref>
 
*Once diagnosed and successfully treated, patients with Meigs syndrome are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].  
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gynecology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 14:52, 26 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Demons Meigs syndrome; Meigs-Cass syndrome; Meigs-Salmon syndrome

Overview

Meigs syndrome (also known as "Meigs-Cass syndrome") is defined as the triad of ascites, pleural effusion, and benign ovarian tumor. Meigs syndrome was first discovered by Otto von Spiegelberg, a German gynecologist, in 1866. There is no classification system established for Meigs syndrome. Other variants of Meigs syndrome include pseudo-meigs syndrome, and atypical Meigs' syndrome. Meigs syndrome may be caused by either ovarian fibroma, Brenner tumor, ovarian thecoma, or granulosa cell tumor. The pathogenesis of Meigs syndrome is characterized by a transudative process. The prevalence of benign ovarian tumors is approximately 2-10%, and only 1-2% develop Meigs syndrome. Meigs syndrome is more commonly observed among postmenopausal women. The median age at diagnosis is approximately 50 years. The majority of patients with Meigs syndrome are asymptomatic. Early clinical features include bloating, fatigue, and shortness of breath. Computed tomography is the imaging modality of choice for Meigs syndrome. On conventional radiography, Meigs syndrome is characterized by blunting of the costophrenic angle or fluid within the horizontal or oblique fissures (250-600 ml of fluid is required before the pleural effusion becomes evident). Surgery is the mainstay of therapy for Meigs syndrome. Exploratory laparotomy with surgical staging is the most common approach to the treatment of Meigs syndrome. Once diagnosed and successfully treated, patients with Meigs syndrome are followed-up every 6 months. Follow-up testing includes; serum cancer antigen 125, ultrasound, and basic metabolic profile.

Historical Perspective

  • Meigs syndrome was first discovered by Otto von Spiegelberg, a German gynecologist, in 1866.[1]
  • Meigs syndrome is named after Joe Vincent Meigs, an American gynecologist who defined Meigs syndrome as the presence of ascites, hydrothorax, association with benign ovarian tumor.[2]
  • In 1900, the first therapeutical surgical approach was developed by Albert Jean Octave Demons to treat Meigs syndrome.[3]

Classification

  • There is no classification system established for Meigs syndrome.[4]
  • Other variants of Meigs syndrome include pseudo-meigs syndrome, and atypical Meigs' syndrome.

Pathophysiology

  • The pathogenesis of Meigs syndrome is characterized by a transudative process.[5]
  • The transudative process consists in the formation of peritoneal and pleural effusion to the filtration of interstitial fluid in the peritoneum through the tumor capsule, and the diffusion to the pleural space.[6]
  • There are no genes associated with the development of Meigs syndrome.
  • On gross pathology, marked ovarian enlargement, watery cut surface, and no necrosis are characteristic findings of Meigs syndrome.[7]
  • On microscopic histopathological analysis, variable stromal luteinization, marked edema of stroma surrounding follicles, and stroma around vessels are characteristic findings of Meigs syndrome.[7]

Causes

  • Meigs syndrome may be caused by either ovarian fibroma, Brenner tumor, ovarian thecoma, or granulosa cell tumor.[8][9]
  • In general, Meigs syndrome may be caused by any benign ovarian tumor.

Differentiating Meigs syndrome from other Diseases

  • Meigs syndrome must be differentiated from other diseases that cause bloating, fatigue, and shortness of breath such as:[10]

Epidemiology and Demographics

Prevalence

  • The prevalence of Meigs syndrome is unknown.[11]
  • The prevalence of benign ovarian tumors is approximately 2-10%, and only 1-2% develop Meigs syndrome.[11]

Age

  • Meigs syndrome is more commonly observed among postmenopausal women.
  • The median age at diagnosis is approximately 50 years.

Gender

  • Meigs syndrome affects exclusively females.

Race

  • There is no racial predilection for Meigs syndrome.
  • Meigs syndrome usually affects females with higher socioeconomic status.[11]

Risk Factors

  • Common risk factors in the development of Meigs syndrome are enlarged adnexal mass ( > 5cm), co-existing pleural effusion, and family history of any form of cancer.[12]

Natural History, Complications and Prognosis

  • The majority of patients with Meigs syndrome are asymptomatic.[11]
  • Early clinical features include bloating, fatigue, and shortness of breath.
  • If left untreated, the majority of patients with Meigs syndrome may progress to develop respiratory failure, ovarian torsion, and hypoproteinemia.
  • Common complications of Meigs syndrome include portal vein obstruction, inferior vena cava obstruction, and thoracic duct obstruction.
  • Prognosis is generally good, and the 5 survival rate of patients with Meigs syndrome is approximately 100%.[11]

Diagnosis

Diagnostic Criteria

  • The diagnosis of Meigs syndrome is made when the following 3 diagnostic criteria are met:
  • Ascities
  • Pleural effusion or hydrothorax
  • Benign ovarian tumor

Symptoms

  • Meigs syndrome is usually asymptomatic.
  • Symptoms of Meigs syndrome may include the following:

Physical Examination

  • Patients with Meigs syndrome are usually well-appearing.
  • Physical examination may be remarkable for:
  • Increased abdominal perimeter
  • Decreased/absent breath sounds
  • Reduced chest expansion
  • Rapid rate of breathing

Laboratory Findings

  • There are no specific laboratory findings associated with Meigs syndrome.
  • In some cases, unspecific laboratory findings may include abnormal serum cancer antigen 125 test and abnormal prothrombin time.

Imaging Findings

  • Computed tomography is the imaging modality of choice for Meigs syndrome.
  • On conventional radiography, Meigs syndrome is characterized by blunting of the costophrenic angle or fluid within the horizontal or oblique fissures (250-600 ml of fluid is required before the pleural effusion becomes evident)
  • On computed tomography, findings include: presence of ascites, and characterization of ovarian mass.
  • Ultrasound may demonstrate and confirm the presence of ovarian mass and ascities.

Other Diagnostic Studies

  • Meigs syndrome may also be diagnosed using thoracentesis or paracentesis.[13]
  • Findings on paracentesis include transudative ascitic fluid, and presence of reactive mesothelial cells.
  • Findings on thoracentesis include transudative pleural fluid, and negative for malignant cells.

Treatment

Medical Therapy

  • There is no medical treatment for Meigs syndrome.

Surgery

  • Surgery is the mainstay of therapy for Meigs syndrome.
  • Exploratory laparotomy with surgical staging is the most common approach to the treatment of Meigs syndrome.
  • Meigs syndrome is a benign condition and the ascites and pleural effusion resolves after resection of the primary pelvic tumor.

Prevention

  • There are no primary preventive measures available for Meigs syndrome.[11]
  • Once diagnosed and successfully treated, patients with Meigs syndrome are followed-up every 6 months.
  • Follow-up testing includes; serum cancer antigen 125, ultrasound, and basic metabolic profile.[11]

References

  1. ↑ Tait L (1892). "On the occurrence of Pleural Effusion in association with Disease of the Abdomen". Med Chir Trans. 75: 109–18. PMC 2036288. PMID 20896800.
  2. ↑ Lurie S (2000). "Meigs' syndrome: the history of the eponym". Eur. J. Obstet. Gynecol. Reprod. Biol. 92 (2): 199–204. PMID 10996681.
  3. ↑ MEIGS JV (1954). "Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome". Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.
  4. ↑ Gil A, Roque A, Alemán C (2015). "[Meigs' syndrome]". Med Clin (Barc) (in Spanish; Castilian). 145 (2): 95. doi:10.1016/j.medcli.2014.12.007. PMID 25662723.
  5. ↑ Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting meigs syndrome. J Bronchology Interv Pulmonol. 2013 Jan. 20(1):48-51.
  6. ↑ Santopaolo O, Rotondo A, Alfè M, Canciello P, Rito Marcone G, Cusati B (1993). "[Meigs syndrome with bilateral hydrothorax]". Minerva Ginecol (in Italian). 45 (5): 263–6. PMID 8351065.
  7. ↑ 7.0 7.1 Ovary - nontumor. Pathology Outlines. http://www.pathologyoutlines.com/topic/ovarymassiveedema.html Accessed on March 29,2016
  8. ↑ Meigs syndrome. Wikipedia. https://en.wikipedia.org/wiki/Meigs'_syndrome Accessed on March 29, 2016
  9. ↑ Meigs syndrome. Radiopedia. http://radiopaedia.org/articles/meigs-syndrome Accessed on March 29, 2016
  10. ↑ Riker D, Goba D (2013). "Ovarian mass, pleural effusion, and ascites: revisiting Meigs syndrome". J Bronchology Interv Pulmonol. 20 (1): 48–51. doi:10.1097/LBR.0b013e31827ccb35. PMID 23328144.
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 Annaiah TK, Reynolds SF, Lopez C (2012). "Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases?". J Obstet Gynaecol. 32 (3): 267–70. doi:10.3109/01443615.2011.626089. PMID 22369402.
  12. ↑ Simpkins F, Zahurak M, Armstrong D, Grumbine F, Bristow R (2005). "Ovarian malignancy in breast cancer patients with an adnexal mass". Obstet Gynecol. 105 (3): 507–13. doi:10.1097/01.AOG.0000154162.51442.14. PMID 15738016.
  13. ↑ Meigs' Syndrome: a case presentation and revision of the literature. http://www.obgyn.net/laparoscopy-and-hysteroscopy/meigs-syndrome-case-presentation-and-revision-literature#sthash.NQ3ZxKLh.dpuf Accessed on March 29, 2016
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