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Abdelgawad M, Barghuthi L, Davis T, Omar M, Kamel OM, Gibbons J, Ragoza Y, Ismael H. Large uterine leiomyoma presenting as pseudo-Meigs’ syndrome with an elevated ca125: a case report and literature review. J Surg Case Rep 2022; 2022:rjac253. [PMID: 35685293 PMCID: PMC9173737 DOI: 10.1093/jscr/rjac253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Ascites, pelvic mass and elevated CA-125 in females carry a grim prognosis, likely an ovarian carcinoma. However, more benign etiologies such as Meigs’ and pseudo-Meigs’ syndrome must be considered. Pseudo-Meigs’ syndrome presenting with an elevated CA-125 is rare and presents a diagnostic challenge. Medline and PubMed were queried for pseudo-Meigs’ syndrome cases. We present a 35-year-old female patient who presented with abdominal swelling and weight gain. Imaging demonstrated a 29-cm large intraabdominal mass with significant ascites with elevation of CA-125. Surgical resection was performed, and pathology identified uterine leiomyoma. Twenty-one cases of pseudo-Meigs’ syndrome were identified in the literature. Most patients presented with abdominal distention, and some also reported dyspnea. All patients, including our case, were treated surgically. No recurrence reported among these cases. Surgery is the mainstay for radical treatment in pseudo-Meigs’ syndrome. Resolution of the ascites and hydrothorax occurs following resection of the tumor.
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Affiliation(s)
- Mohamed Abdelgawad
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
| | - Lutfi Barghuthi
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
| | - Tyler Davis
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
| | - Mahmoud Omar
- Department of Surgery , School of Medicine, Tulane University, New Orleans, LA, USA
| | - Omar M Kamel
- Department of Surgery , School of Medicine, Tulane University, New Orleans, LA, USA
| | - Jake Gibbons
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
| | - Yury Ragoza
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
| | - Hishaam Ismael
- Department of Surgery , University of Texas Health Science Center, UT Health East Texas, Tyler, TX, USA
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Adlan AS, Chua PT, Huang KG. Laparoscopic Resection of a Subserosal Leiomyoma Presenting as Pseudo–Meigs' Syndrome. J Gynecol Surg 2020. [DOI: 10.1089/gyn.2019.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aizura-Syafinaz Adlan
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peng Teng Chua
- Department of Obstetrics and Gynaecology, Mahkota Medical Centre, Melaka, Malaysia
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkouter Medical Center and Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan
| | - Kuan-Gen Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkouter Medical Center and Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan
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Musleh JKM, Almulhem M, Al Qahtani NH. Massive ascites, pelvic mass, elevated CA-125 and weight loss: think outside the 'ovaries'. BMJ Case Rep 2017; 2017:bcr-2016-217497. [PMID: 28801321 DOI: 10.1136/bcr-2016-217497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 44-year-old woman presented with 3 months' history of painless progressive abdominal distension and weight loss of more than 15 kg. Clinically a pelviabdominal mass with ascites was detected. CT scan of the pelvis and abdomen showed a subserosal leiomyoma with huge amount of ascites. Cancer Antigen (CA)-125 was 546 kU/L. Exploratory laparotomy with myomectomy was done and this was followed by dramatic improvement postoperatively.
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Affiliation(s)
| | - Mohammed Almulhem
- Department of Obstetrics and Gynaecology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nourah Hasan Al Qahtani
- Department of Obstetrics and Gynaecology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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