Meigs syndrome

Meigs' syndrome, named after Thornton Meigs, is a rare medical condition characterized by the triad of ascites, hydrothorax, and benign ovarian tumors, typically fibromas. The syndrome is particularly notable because the ascites and hydrothorax resolve after the removal of the tumor. Although Meigs' syndrome is primarily associated with ovarian fibromas, similar symptoms can be observed with other types of ovarian tumors, leading to the broader term "pseudo-Meigs' syndrome" for these cases.

Etiology

The exact cause of Meigs' syndrome remains unclear, but it is believed to involve the mechanical and biological effects of the tumor on the lymphatic system and surrounding tissues. The ovarian tumor may lead to increased pressure on lymphatic vessels, impairing the drainage of fluid and resulting in the accumulation of fluid in the abdomen (ascites) and the pleural cavity (hydrothorax).

Symptoms

Patients with Meigs' syndrome typically present with:

• Ascites: An abnormal accumulation of fluid in the abdominal cavity.
• Hydrothorax: The collection of fluid in the pleural cavity, often leading to difficulty breathing.
• A pelvic mass: Usually a benign ovarian fibroma.

Other symptoms may include weight gain, abdominal discomfort or pain, and respiratory symptoms due to the hydrothorax.

Diagnosis

Diagnosis of Meigs' syndrome involves a combination of clinical examination, imaging, and laboratory tests. Imaging techniques such as ultrasound, CT scan, and MRI can help identify the ovarian tumor and the presence of ascites and hydrothorax. Laboratory tests may show elevated levels of tumor markers, although these are not specific to Meigs' syndrome. The definitive diagnosis is often made after surgical removal and histopathological examination of the tumor.

Treatment

The primary treatment for Meigs' syndrome is the surgical removal of the ovarian tumor. This procedure typically leads to the resolution of ascites and hydrothorax. In some cases, additional treatments may be necessary to manage symptoms before surgery, such as therapeutic paracentesis to remove excess abdominal fluid.

Prognosis

The prognosis for patients with Meigs' syndrome is generally excellent, as the condition usually resolves completely with the removal of the tumor. The tumors associated with Meigs' syndrome are benign, and once removed, the symptoms of ascites and hydrothorax typically resolve without further intervention.

Epidemiology

Meigs' syndrome is a rare condition, with the exact incidence unknown. It most commonly affects middle-aged women, but cases have been reported in a wide range of ages.

See also

• Ovarian cancer
• Ascites
• Hydrothorax
• Fibroma