Meigs' syndrome with elevated CA 125: case report. (1/11)

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.  (+info)

A long surviving case of Pseudomeigs' syndrome caused by Krukenberg tumor of the stomach. (2/11)

Meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolve after resection of the tumor. Pseudomeigs' syndrome is a serious disease characterized by malignant ovarian tumor, but ascites and hydrothorax usually reveal no malignant cells. Here, we report a 47-year-old pre-menapausal female patient with cardia cancer. Nearly 14 months after D3 dissection, she developed Krukenberg tumors on both ovaries causing a Pseudomeigs' syndrome with benign ascites and right hydrothorax, which resolved dramatically after resection of the tumors and rectouterine pouch peritonectomy. She survived nearly 3 years after metastasectomy with a total survival of 46 months. The patient died because of massive liver metastases. The present case suggests that Pseudomeigs' syndrome should be considered in patients with Krukenberg tumors, ascites and hydrothorax and that resection of the tumors may bring long-term palliation.  (+info)

Pseudo-Meigs' syndrome associated to renal pelvis tumor. (3/11)

INTRODUCTION: Pseudo-Meigs' syndrome is associated with tumors different from the benign ovary tumor, but it has never been described in association to transitional cell carcinoma. CASE REPORT: A female 73 year-old patient presenting pleural effusion nonmetastatic associated with renal pelvis transitional cell carcinoma that resolved and did not recur after radical nephroureterectomy. COMMENTS: Renal pelvis transitional cell carcinoma can result in the Pseudo-Meigs' syndrome. Although being a rare clinical entity, the identification of such syndrome can result in an accurate diagnosis, leading to an efficient surgical treatment, without comorbidity for the patient.  (+info)

Meigs' syndrome in a young woman with a normal serum CA-125 level. (4/11)

We report on a 27-year-old woman who presented with an ovarian solid tumor (20 x 15 cm) and massive ascites. A physical examination and chest X-ray revealed a moderate amount of pleural effusion on the right side. Cytologic study of the pleural effusion showed reactive mesothelial cells without evidence of malignancy. Gram's stain was negative. The blood chemistry was within normal limits. The serum CA-125 level was 22 (normal, < 35) U/ml, the alpha-fetoprotein (AFP) level was 8 (normal, < 20) ng/ml, and the carcinoembryonic antigen (CEA) was 0.5 (normal, < 5) ng/ml. An explorative laparotomy revealed approximately 1500 ml of serous ascites and a very large multilobulated left adnexal mass (20 x 15 cm) with no malignant cytology in the ascitic fluid. Postoperatively, the pleural effusion spontaneously resolved, and the microscopic examination revealed a benign fibroma-thecoma, confirming the diagnosis of Meigs' syndrome. The symptoms resolved after removal of this pelvic tumor. This is an unusual case of a young female with Meigs' syndrome and a normal serum CA-125 level.  (+info)

Silent event-related fMRI reveals deficient motor and enhanced somatosensory activation in orofacial dystonia. (5/11)

Previous studies showed cortical dysfunction and impaired sensorimotor integration in primary generalized and focal hand dystonia. We used a whistling task and silent event-related fMRI to investigate functional changes in patients with blepharospasm and patients with a combination of blepharospasm and oromandibular dystonia (Meige's syndrome). Whistling served as a model for a skilful orofacial movement with a high demand on sensorimotor integration. It allowed us to study the oromandibular motor system that is clinically affected in Meige's syndrome but not in isolated blepharospasm. In Meige's syndrome, functional MRI revealed deficient activation of the primary motor and ventral premotor cortex within the mouth representation area during whistling. Compared with healthy controls, both forms of orofacial dystonia had increased activation of bilateral somatosensory areas and the caudal supplementary motor area (SMA) in common. While overactivity of somatosensory areas and caudal SMA in Meige patients was partly reversed by botulinum toxin treatment, impaired motor activation was not. We conclude that impaired motor activation appears to be specific for the clinically affected oromandibular motor system in Meige's syndrome while enhanced somatosensory activation is a common abnormality in both forms of orofacial dystonia independent of the affected motor system. Somatosensory overactivity indicates an altered somatosensory representation in orofacial dystonia while impaired motor activation may be a functional correlate of reduced cortical inhibition during oromandibular motor execution in Meige's syndrome.  (+info)

Pseudo-Meigs' syndrome caused by breast cancer metastasis to both ovaries. (6/11)

We report a rare case of pseudo-Meigs' syndrome due to metastasis of breast cancer to both ovaries. A 34-year-old woman with exertional dyspnea was admitted to our hospital. Before entry the patient had undergone radical mastectomy for left breast cancer in June 1998. Resection and reconstruction of the chest wall for recurrence of the breast cancer had been performed in April 2001. Right pleural effusion was found on admission to our hospital in October 2002. Continuous thoracic drainage obtained 500-2000 ml of fluid per day. Cytologic results were both normal and benign, and cultures for bacteria and acid-fast bacilli were negative. During treatment of the pleural effusion, which proved to be cryptogenic and intractable, a huge pelvic tumor was found. The primary site was unknown. Surgery was performed in November 2002, and tumors were removed from both ovaries. The right pleural effusion vanished after surgery. Pseudo-Meigs' syndrome with metastasis of breast cancer to both ovaries was diagnosed. The patient died of cachexia related to the carcinoma in January 2005.  (+info)

Bilateral benign non functional struma ovarii with Pseudo-Meigs' syndrome. (7/11)

Bilateral presentation of benign Struma ovarii is rare and has not been reported frequently in published literature. A 70-year-old postmenopausal female presented with progressive ascites, bilateral pleural effusion and elevated CA-125 levels. The contrast-enhanced computed tomography (CECT) of the abdomen and pelvis revealed a heterogenous mass in the left adnexa. These findings were suspicious for an ovarian malignancy. After surgery the diagnosis of non functional, bilateral benign Struma ovarii was made. Struma ovarii is a specialized ovarian teratoma composed predominantly of mature thyroid tissue. It is associated with pleural effusion and ascites (Pseudo-Meigs' syndrome) in 5% of cases. The combination of struma ovarii and elevated CA-125 levels has been reported infrequently. This is a rare case of bilateral benign struma ovarii associated with Pseudo-Meigs' syndrome and elevated CA-125 levels. Surgical excision of the ovarian masses induced immediate resolution of the ascites and pleural effusion and a reduction of the serum CA-125 level.  (+info)

A case of Meigs syndrome mimicking metastatic breast carcinoma. (8/11)

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