Meigs' syndrome

Meigs' syndrome is a rare medical condition characterized by the triad of ascites, hydrothorax, and benign ovarian tumors, typically fibromas. The syndrome is named after Thornton Meigs, who first described the condition in detail in the 1930s. Meigs' syndrome is of particular interest in the fields of gynecology and oncology, as it involves the intersection of benign gynecological tumors and symptoms that mimic more serious conditions such as ovarian cancer.

Etiology

The exact cause of Meigs' syndrome remains unclear. However, it is believed that the ascites and hydrothorax result from the mechanical and biological effects of the ovarian tumor. The tumor may produce substances that encourage fluid production or obstruct lymphatic drainage, leading to fluid accumulation in the abdomen (ascites) and the pleural cavity (hydrothorax).

Clinical Presentation

Patients with Meigs' syndrome typically present with abdominal swelling due to ascites, and may also experience shortness of breath due to hydrothorax. On physical examination, a pelvic mass may be palpable, corresponding to the ovarian tumor. The symptoms of Meigs' syndrome can mimic those of more serious conditions, including ovarian cancer, which necessitates thorough diagnostic evaluation.

Diagnosis

The diagnosis of Meigs' syndrome involves a combination of clinical evaluation, imaging studies, and laboratory tests. Ultrasound or CT scans can help identify the ovarian tumor and assess the extent of ascites and hydrothorax. Laboratory tests, including tumor markers like CA-125, are typically normal or only slightly elevated in Meigs' syndrome, which can help differentiate it from ovarian cancer.

Treatment

The primary treatment for Meigs' syndrome is the surgical removal of the ovarian tumor. This procedure often leads to the resolution of ascites and hydrothorax. In some cases, additional interventions may be required to manage ascites and hydrothorax before surgery.

Prognosis

The prognosis for Meigs' syndrome is generally excellent, as the condition resolves with the removal of the tumor. Unlike malignant ovarian tumors, Meigs' syndrome does not spread to other parts of the body, and the symptoms are fully reversible upon treatment.

Differential Diagnosis

The differential diagnosis for Meigs' syndrome includes other causes of ascites and hydrothorax, such as ovarian cancer, heart failure, cirrhosis, and tuberculosis. Distinguishing Meigs' syndrome from these conditions is crucial for appropriate management.

Epidemiology

Meigs' syndrome is a rare condition, with the exact incidence unknown. It most commonly affects women in their middle to late reproductive years, but it can occur at any age.