Meigs syndrome: Difference between revisions

	WikiDoc Resources for Meigs syndrome
Articles
Most recent articles on Meigs syndrome Most cited articles on Meigs syndrome Review articles on Meigs syndrome Articles on Meigs syndrome in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Meigs syndrome Images of Meigs syndrome Photos of Meigs syndrome Podcasts & MP3s on Meigs syndrome Videos on Meigs syndrome
Evidence Based Medicine
Cochrane Collaboration on Meigs syndrome Bandolier on Meigs syndrome TRIP on Meigs syndrome
Clinical Trials
Ongoing Trials on Meigs syndrome at Clinical Trials.gov Trial results on Meigs syndrome Clinical Trials on Meigs syndrome at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Meigs syndrome NICE Guidance on Meigs syndrome NHS PRODIGY Guidance FDA on Meigs syndrome CDC on Meigs syndrome
Books
Books on Meigs syndrome
News
Meigs syndrome in the news Be alerted to news on Meigs syndrome News trends on Meigs syndrome
Commentary
Blogs on Meigs syndrome
Definitions
Definitions of Meigs syndrome
Patient Resources / Community
Patient resources on Meigs syndrome Discussion groups on Meigs syndrome Patient Handouts on Meigs syndrome Directions to Hospitals Treating Meigs syndrome Risk calculators and risk factors for Meigs syndrome
Healthcare Provider Resources
Symptoms of Meigs syndrome Causes & Risk Factors for Meigs syndrome Diagnostic studies for Meigs syndrome Treatment of Meigs syndrome
Continuing Medical Education (CME)
CME Programs on Meigs syndrome
International
Meigs syndrome en Espanol Meigs syndrome en Francais
Business
Meigs syndrome in the Marketplace Patents on Meigs syndrome
Experimental / Informatics
List of terms related to Meigs syndrome

VisualWikitext

Latest revision as of 14:52, 26 February 2019

For patient information, please click here

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

↑ 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.
↑ Lurie S (2000). "Meigs' syndrome: the history of the eponym". Eur. J. Obstet. Gynecol. Reprod. Biol. 92 (2): 199–204. PMID 10996681.
↑ MEIGS JV (1954). "Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome". Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.
↑ 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.
↑ Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting meigs syndrome. J Bronchology Interv Pulmonol. 2013 Jan. 20(1):48-51.
↑ 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.
↑ ^7.0 ^7.1 Ovary - nontumor. Pathology Outlines. http://www.pathologyoutlines.com/topic/ovarymassiveedema.html Accessed on March 29,2016
↑ Meigs syndrome. Wikipedia. https://en.wikipedia.org/wiki/Meigs'_syndrome Accessed on March 29, 2016
↑ Meigs syndrome. Radiopedia. http://radiopaedia.org/articles/meigs-syndrome Accessed on March 29, 2016
↑ 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.
↑ ^11.0 ^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.
↑ 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.
↑ 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

[pmid20896800-1] 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.

[pmid10996681-2] Lurie S (2000). "Meigs' syndrome: the history of the eponym". Eur. J. Obstet. Gynecol. Reprod. Biol. 92 (2): 199–204. PMID 10996681.

[pmid13148256-3] MEIGS JV (1954). "Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome". Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.

[pmid25662723-4] 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.

[ppp-5] Riker D, Goba D. Ovarian mass, pleural effusion, and ascites: revisiting meigs syndrome. J Bronchology Interv Pulmonol. 2013 Jan. 20(1):48-51.

[pmid8351065-6] 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.

[pathologyoutlines-7] 7.0 ^7.1 Ovary - nontumor. Pathology Outlines. http://www.pathologyoutlines.com/topic/ovarymassiveedema.html Accessed on March 29,2016

[wiki-8] Meigs syndrome. Wikipedia. https://en.wikipedia.org/wiki/Meigs'_syndrome Accessed on March 29, 2016

[radio-9] Meigs syndrome. Radiopedia. http://radiopaedia.org/articles/meigs-syndrome Accessed on March 29, 2016

[pmid23328144-10] 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.

[pmid22369402-11] 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.

[pmid15738016-12] 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.

[laparoscopy-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

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

@@ Line 1: / Line 1: @@
-{{Infobox_Disease |
+__NOTOC__
-  Name           = {{PAGENAME}} |
+{{SI}}
-  Image          = |
-  Caption        = |
-  DiseasesDB     = |
-  ICD10          = |
-  ICD9           = |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = |
-  eMedicineSubj  = med |
-  eMedicineTopic = 1422 |
-}}
-{{SI}}
-{{EH}}
+'''For patient information, please click [[Meigs syndrome (patient information)|here]]'''
+{{CMG}} {{AE}} {{MV}}
+{{SK}} Demons Meigs syndrome; Meigs-Cass syndrome; Meigs-Salmon syndrome
+==Overview==
-In [[medicine]], '''Meigs syndrome''', also '''Meigs' syndrome''', is the triad of benign [[ovarian tumor]] ([[fibroma]], [[thecoma]], [[cystadenoma]], or [[granulosa cell tumor]]), [[ascites]] and [[pleural effusion]].<ref>Lessnau K, Chavda R. Meigs syndrome. eMedicine.com. URL: [http://www.emedicine.com/med/topic1422.htm http://www.emedicine.com/med/topic1422.htm]. Accessed on: February 26, 2007.</ref>  It resolves after the resection of the tumor.  For reasons unknown, the pleural effusion is classically on the right side.  (Note: '''Meigs' Syndrome''' is not to be confused with '''[[Meige's syndrome]]''')
+'''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.
-Because of the presence of ascites and pleural effusions, the [[differential diagnosis]] includes [[liver failure]] ([[cirrhosis]]), [[congestive heart failure]], [[renal disease]]s, and [[metastatic tumor]]s to the peritoneal surfaces.  These entities must be clinically excluded.{{Fact|date=February 2007}}
+==Historical Perspective==
+*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 is named after Joe Vincent Meigs, an American gynecologist who defined Meigs syndrome as the presence of ascites, hydrothorax, association with benign ovarian tumor.<ref name="pmid10996681">{{cite journal |vauthors=Lurie S |title=Meigs' syndrome: the history of the eponym |journal=Eur. J. Obstet. Gynecol. Reprod. Biol. |volume=92 |issue=2 |pages=199–204 |year=2000 |pmid=10996681 |doi= |url=}}</ref>
+*In 1900, the first therapeutical surgical approach was developed by Albert Jean Octave Demons to treat Meigs syndrome.<ref name="pmid13148256">{{cite journal |vauthors=MEIGS JV |title=Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome |journal=Am. J. Obstet. Gynecol. |volume=67 |issue=5 |pages=962–85 |year=1954 |pmid=13148256 |doi= |url=}}</ref>
-Treatment of Meigs' syndrome consists of [[thoracentesis]] and [[paracentesis]] to drain off the excess fluid, and unilateral [[oophorectomy|salpingo-oophorectomy]] to correct the underlying [[etiology]].
+==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>
+*Other variants of Meigs syndrome include pseudo-meigs syndrome, and atypical Meigs' syndrome.
-==References==
+==Pathophysiology==
-<references/>
+*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 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>
+*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.<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==
+* 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>
+* 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:<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>
+:*[[Ovarian cancer]]
+:*[[Cirrhosis]]
+:*[[Colon cancer]]
+:*[[Tuberculosis]]
+:*Milroy's disease
+==Epidemiology and Demographics==
+===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===
+*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.<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>
-==External link==
+==Risk Factors==
-*[http://www.emedicine.com/med/topic1422.htm Meigs syndrome] - emedicine.com
+*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>
-{{SIB}}
+== Natural History, Complications and Prognosis==
+*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 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%.<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 ==
+===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:
+:*[[Bloating]]
+:*[[Fatigue]]
+:*[[Weight-loss]]
+:*[[Shortness of breath]]
+:*[[Cough]]
+:*[[Menstrual disorder|Menstrual irregularity]]
+=== 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
-[[Category:Gynecology]]
+=== Laboratory Findings ===
+*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.
+===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.<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.
-[[pl:Zespół Meigsa]]
+== 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.
-{{WH}}
+=== Prevention ===
-{{WikiDoc Sources}}
+*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.
+*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>
+==References==
+{{Reflist|2}}
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Gynecology]]
+[[Category:Gastroenterology]]
+[[Category:Surgery]]