Meigs Syndrome

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Meigs syndrome is the triad of ascites, pleural effusion and benign ovarian tumor (fibroma) which resolves after resection of the ovarian tumor. The syndrome was named for Joe Vincent Meigs (1892-1963), a professor of gynecology at Harvard Medical School.

What is the pathophysiolgy?

1. Pathophysiolgy of ascites:  Exact pathophysiolgy of ascites is still unknown but different research suggested that irritation of the peritoneal surfaces by ovarian could stimulate the production of peritoneal fluid.
2. Pathophysiolgy of pleural effusion: the exact etiology of the pleural effusion is unclear but size of the pleural effusion is largely independent of the amount of ascites.

What are the signs and symptom of Meigs syndrome?

1. Fatigue
2. Shortness of breath
3. Increased abdominal size
4. Nonproductive cough
5. Weight loss
6. Amenorrhea for premenopausal women
7. Menstrual irregularity
8. Bloating
9. Tachycardia
10. Dullness of percussion of lungs
11. Abdominal examination may felt the mass
12. Present of ascites
13. Present of pelvic mass

What is the Differential Diagnosis of Meigs syndrome?

1. Liver failure (cirrhosis)
2. Congestive heart failure
3. Renal failure
4. Metastatic tumors
5. Malnutrition
6. Tuberculosis
7. Lung Cancer, Non-Small Cell
8. Ovarian Cancer

How to diagnose Meigs syndrome?

Diagnosis of Meigs syndrome is relies on Patients history, physical exam, lab test, Imaging studies and histologic findings.

Laboratory tests:

1. CBC, sodium, potassium, chloride, bicarbonate, blood urea nitrogen, creatatine, and glucose level need to be done before operation.
2. Tumor marker serum levels of CA-125 can be elevated in Meigs syndrome.

Imaging studies:

• X-ray confirm pleural effusion
• Ultrasound confirm the ascites and ovarian mass
• CT-scan for ascites, ovarian mass, and no signs of metastasis.

Histologic studies ? Histologic studies shows different type of benign tumor.

How to manage Meigs syndrome?

Management of Meigs syndrome consists of thoracentesis and paracentesis to drain off the excess fluid for symptomatic relief.

Unilateral salpingo-oophorectomy or wedge resection is the treatment of choice for Meigs syndrome.

What is the prognosis of Meigs syndrome?

After the surgery the prognosis is excellent.

References:

• emedicine.medscape.com
• www.nlm.nih.gov
• healthguide.howstuffworks.com
• www.mayoclinic.org
• www.patient.co.uk
• www.healthcentral.com
• www.wrongdiagnosis.com
• en.wikipedia.org
• books.google.com
• www.femalepatient.com

Filed Under: Female Health

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