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Omori G, Arihara Y, Abe T, Takada K, Suzuki N, Shibuya R, Ikeda Y, Yamada M, Ono M, Fujita M, Sugita S, Maeda M. A Case of Atypical Pseudo-Meigs' Syndrome without Pleural Effusion due to Ovarian Metastasis from Sigmoid Colon Cancer. Intern Med 2022; 62:1487-1493. [PMID: 36223922 DOI: 10.2169/internalmedicine.0157-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a case of atypical pseudo-Meigs' syndrome without pleural effusion. A 46-year-old woman was diagnosed with an ovarian tumor and sigmoid colon cancer with massive ascites. She underwent surgical resection of the sigmoid colon and bilateral salpingo-oophorectomy. The pathological diagnosis was sigmoid colon cancer with ovarian metastasis. A few days after the operation, the massive ascites disappeared. Immunostaining for vascular endothelial growth factor (VEGF) suggested its overproduction was involved in the development of the ascites. Although cases of pseudo-Meigs' syndrome without pleural effusion are rare, reporting such cases will facilitate the choice of more appropriate treatment strategies in future.
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Affiliation(s)
- Ginji Omori
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Yohei Arihara
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Japan
| | - Tomoyuki Abe
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Japan
| | - Norito Suzuki
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Ryo Shibuya
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Yuki Ikeda
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Michiko Yamada
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Michihiro Ono
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Miri Fujita
- Department of Pathology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Japan
| | - Masahiro Maeda
- Department of Gastroenterology, Social Medical Corporation Steel Memorial Muroran Hospital, Japan
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Tajima Y, Kameyama H, Yamada S, Yagi R, Nakano M, Nagahashi M, Shimada Y, Sakata J, Kobayashi T, Umezu H, Wakai T. Long-term survival in pseudo-Meigs' syndrome caused by ovarian metastases from colon cancer. World J Surg Oncol 2016; 14:286. [PMID: 27842595 PMCID: PMC5109729 DOI: 10.1186/s12957-016-1040-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/04/2016] [Indexed: 02/08/2023] Open
Abstract
Background Meigs’ syndrome is defined as the co-existence of benign ovarian fibroma or fibroma-like tumor, ascites, and pleural effusion. In contrast, pseudo-Meigs’ syndrome is defined as the co-existence of other ovarian or pelvic tumors, ascites, and pleural effusion. In Meigs’ and pseudo-Meigs’ syndromes, ascites and pleural effusion resolve promptly after the complete resection of the ovarian or pelvic tumor(s). Secondary ovarian tumors from colorectal gastrointestinal metastases rarely cause pseudo-Meigs’ syndrome; only 11 cases of pseudo-Meigs’ syndrome secondary to colorectal cancers have been reported in the literature. Therefore, the prognosis and etiology of pseudo-Meigs’ syndrome caused by ovarian metastasis from colorectal cancers remain unclear. Case presentation We report here a rare case of pseudo-Meigs’ syndrome caused by ovarian metastases from sigmoid colon cancer with long-term survival. A 47-year-old woman presented with abdominal distention of 1-month duration. She developed acute dyspnea 2 weeks after the initial presentation. Colonoscopy and computed tomography revealed sigmoid colon cancer with an ovarian metastasis, along with massive ascites and bilateral pleural effusion. Emergency operation, including bilateral oophorectomy and sigmoidectomy, was performed. Subsequently, ascites and bilateral pleural effusion resolved rapidly. Curative hepatic resection was performed for liver metastases 29 months after the first operation, and as of this writing, the patient is alive with no evidence of a disease 78 months after the first operation. In general, colorectal cancer with ovarian metastasis is hard to cure, and long-term survival in patients with colorectal cancer with pseudo-Meigs’ syndrome is rare. Our experience suggests that curative resection for pseudo-Meigs’ syndrome caused by ovarian metastasis from colorectal cancer may offer long-term survival. Conclusions Our experience suggests that pseudo-Meigs’ syndrome can occur in a patient with colorectal cancer after metastasis to the ovaries, causing massive ascites and pleural effusion. Aggressive treatment, including R0 resection, for this disease if allowed by the patient’s general condition may offer long-term survival.
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Affiliation(s)
- Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Saki Yamada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Ryoma Yagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hajime Umezu
- Division of Pathology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
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Yamamoto A, Miyasaka Y, Furuya K, Watanabe H, Maruyama M, Nakada H, Takano A, Hada M, Nakagomi H, Omata M, Oyama T. Pseudo-Meigs' syndrome due to ovarian metastases from colon cancer: a case report and review of the literature. Surg Case Rep 2016; 2:112. [PMID: 27734419 PMCID: PMC5061673 DOI: 10.1186/s40792-016-0209-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/01/2016] [Indexed: 02/08/2023] Open
Abstract
We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A 57-year-old female visited a hospital for a 2-month history of abdominal distension and voiding difficulty. Massive pleural effusion on the right side and a small amount of left-sided pleural effusion were detected on CT. She underwent emergent laparotomy due to the severe symptom of abdominal distention. The tumor originated from the left ovary, and left-sided oophorectomy was performed.The histologic finding was moderately differentiated adenocarcinoma suggesting metastatic carcinoma from the colon. Left thoracic effusion disappeared at 3 days after the removal of the ovarian tumor. Subsequently, colon carcinoma of the cecum was detected by colonoscopy. The patient underwent second laparotomy of right colectomy and lymph node dissection. However, 6 months after the operation, pleural effusion on the right side re-developed again, and the serum levels of CEA and CA125 were elevated at 105 ng/ml and 125 U/ml, respectively. CT again revealed a large ovarian tumor. She subsequently underwent third laparotomy of right-sided oophorectomy and hysterectomy. Pleural effusion and ascites disappeared in a few days after the operation.The patient developed both synchronous and metachronous ovarian metastases and achieved a 7-year disease-free survival after the operation. The pathogenesis of pseudo-Meigs' syndrome should be distinguished from carcinomatous peritonitis and/or pleuritis of malignant disease.
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Affiliation(s)
- Atsushi Yamamoto
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan.
| | - Yoshiaki Miyasaka
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Kazushige Furuya
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Hideki Watanabe
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Masahiro Maruyama
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Haruka Nakada
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Atsushi Takano
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Masao Hada
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Hiroshi Nakagomi
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Masao Omata
- Department Internal Medicine, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Toshio Oyama
- Department Pathology, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
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Kyo K, Maema A, Shirakawa M, Nakamura T, Koda K, Yokoyama H. Pseudo-Meigs’ syndrome secondary to metachronous ovarian metastases from transverse colon cancer. World J Gastroenterol 2016; 22:4604-4609. [PMID: 27182170 PMCID: PMC4858642 DOI: 10.3748/wjg.v22.i18.4604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/02/2016] [Accepted: 03/14/2016] [Indexed: 02/06/2023] Open
Abstract
Pseudo-Meigs’ syndrome associated with colorectal cancer is extremely rare. We report here a case of pseudo-Meigs’ syndrome secondary to metachronous ovarian metastases from colon cancer. A 65-year-old female with a history of surgery for transverse colon cancer and peritoneal dissemination suffered from metachronous ovarian metastases during treatment with systemic chemotherapy. At first, neither ascites nor pleural effusion was observed, but she later complained of progressive abdominal distention and dyspnea caused by rapidly increasing ascites and pleural effusion and rapidly enlarging ovarian metastases. Abdominocenteses were repeated, and cytological examinations of the fluids were all negative for malignant cells. We suspected pseudo-Meigs’ syndrome, and bilateral oophorectomies were performed after thorough informed consent. The patient’s postoperative condition improved rapidly after surgery. We conclude that pseudo-Meigs’ syndrome should be included in the differential diagnosis of massive or rapidly increasing ascites and pleural effusion associated with large or rapidly enlarging ovarian tumors.
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Etiology of Ascites and Pleural Effusion Associated with Ovarian Tumors: Literature Review and Case Reports of Three Ovarian Tumors Presenting with Massive Ascites, but without Peritoneal Dissemination. Case Rep Obstet Gynecol 2015; 2015:414019. [PMID: 26858849 PMCID: PMC4697079 DOI: 10.1155/2015/414019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/06/2015] [Accepted: 10/18/2015] [Indexed: 12/15/2022] Open
Abstract
Borderline ovarian tumors are benign but relatively large tumors that are often initially mistaken as ovarian cancers. We report three cases of stage I borderline ovarian tumors having massive ascites that we (preoperatively) suspected of being advanced ovarian cancer. The three patients (35, 47, and 73 years old) reported feeling fullness of the abdomen before consulting their gynecologist. By CT scan, they were diagnosed with a pelvic tumor accompanied by massive ascites, the diameters of which were 11, 20, and 11 cm, respectively. Postsurgical pathology showed all were stage I borderline ovarian tumors without dissemination; two were mucinous and one was serous. The amount of ascites was 6,300, 2,600, and 3,600 mL, respectively, and was serous in all. Cytodiagnosis of the ascites found that one was positive for tumor cells and two were negative. After resection of the mass, the ascites disappeared in all three cases. No pleural effusion was present at any time. The literature is reviewed concerning ascites and pleural effusions linked to ovarian tumors, and a supposition is forwarded of why pleural effusion presents sporadically in these cases.
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Oldrini G, Renard-Oldrini S, Vogin G, Marchal F, Grignon B, Henrot P. [Ascites, pleural effusion and ovarian lesion]. Presse Med 2015; 44:1076-8. [PMID: 26319769 DOI: 10.1016/j.lpm.2015.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/24/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Guillaume Oldrini
- Institut de cancérologie de Lorraine, service de radiologie, 6, avenue de Bourgogne, CS 30519, 54519 Vandoeuvre-lès-Nancy cedex, France.
| | - Sophie Renard-Oldrini
- Institut de cancérologie de Lorraine, service de radiothérapie, 6, avenue de Bourgogne, CS 30519, 54519 Vandoeuvre-lès-Nancy cedex, France
| | - Guillaume Vogin
- Institut de cancérologie de Lorraine, service de radiothérapie, 6, avenue de Bourgogne, CS 30519, 54519 Vandoeuvre-lès-Nancy cedex, France
| | - Frédéric Marchal
- Institut de cancérologie de Lorraine, service de chirurgie, 6, avenue de Bourgogne, CS 30519, 54519 Vandoeuvre-lès-Nancy cedex, France
| | - Bruno Grignon
- CHU Nancy, service d'imagerie Guilloz, avenue de Lattre-de-Tassigny, 54000 Nancy, France
| | - Philippe Henrot
- Institut de cancérologie de Lorraine, service de radiologie, 6, avenue de Bourgogne, CS 30519, 54519 Vandoeuvre-lès-Nancy cedex, France
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Maeda H, Okabayashi T, Hanazaki K, Kobayashi M. Clinical experience of Pseudo-Meigs’ Syndrome due to colon cancer. World J Gastroenterol 2011; 17:3263-6. [PMID: 21912477 PMCID: PMC3158404 DOI: 10.3748/wjg.v17.i27.3263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 03/01/2011] [Accepted: 03/08/2011] [Indexed: 02/06/2023] Open
Abstract
We report a rare case of Pseudo-Meigs’ Syndrome caused by ovarian metastasis from sigmoid colon cancer, which was accompanied by peritoneal dissemination. A 58-year-old female patient presented with massive right pleural effusion, ascites and a huge pelvic mass. Under the diagnosis of an advanced ovarian tumor, bilateral oophorectomy was performed and sigmoidectomy was also carried out after intraoperative diagnosis of peritoneal dissemination involving the sigmoid colon. However, immunohistochemical staining revealed that the ovarian lesions were metastasis from the primary advanced colon cancer. Postoperatively, ascites and pleural effusion subsided, and the diagnosis of Pseudo-Meigs’ Syndrome due to a metastatic ovarian tumor from colon cancer was determined. The patient is now undergoing a regimen of chemotherapy for colon cancer without recurrence of ascites or hydrothorax 10 mo after the surgery. Pseudo-Meigs’ Syndrome due to a metastatic ovarian tumor from colon cancer is rare but clinically important because long-term alleviation of symptoms can be achieved by surgical resection. This case report suggests that selected patients, even with peritoneal dissemination, may obtain palliation from surgical resection of metastatic ovarian tumors.
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Marci R, Giugliano E, Carboni S, Martinello R, Patella A. Pseudo-Meigs' syndrome caused by a uterine leiomyosarcoma: a new clinical condition. Gynecol Obstet Invest 2011; 72:68-72. [PMID: 21625074 DOI: 10.1159/000327931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 03/29/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Pseudo-Meigs' syndrome is a rare condition characterized by female genital cancer, ascites, hydrothorax and tumors other than benign ovarian tumors. CASE REPORT A 30-year-old woman arrived at our clinic with pelvic pain and dyspnea. She underwent an exploratory laparotomy for a large pelvic mass complicated by ascites and hydrothorax. Cytological examination of the effusions was negative for malignant cells. Histological analysis of the tumor mass revealed a uterine epithelioid leiomyosarcoma. After surgery, we observed resolution of the effusions. CONCLUSION Uterine leiomyosarcoma and pseudo-Meigs' syndrome are two rare entities. To our knowledge, there are no similar reports in the literature, and therefore we present this new clinical condition due to its high scientific evidence.
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Affiliation(s)
- Roberto Marci
- Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy
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