Citation, DOI and article data
Meigs syndrome is defined as the presence of ascites and pleural effusion in association with a benign, usually solid ovarian tumor. In the vast majority (80-90%) of cases, the primary tumor is an ovarian fibroma. Less than 1% of ovarian tumors present with this syndrome 8. Other primary tumors include:
Most presentations occur in post-menopausal women with peak incidence at approximately 7th decade of life. It is extremely rare in women aged less than 30 years old.
The pathophysiology of ascites in Meigs syndrome is speculative. It was initially suggested that irritation of the peritoneal surfaces by a hard, solid ovarian tumor could stimulate peritoneal fluid production. The pathophysiology of the pleural effusion is also speculative with some suggesting ascitic fluid being transferred via trans-diaphragmatic lymphatic channels into the pleural space.
The pleural fluid tends to be right sided in a majority (~60-70%) of cases.
Treatment and prognosis
The condition is benign and the ascites and pleural effusion resolve after resection of the primary pelvic tumor.
History and etymology
Named after Joe Vincent Meigs (1892-1963), an American (US) obstetrician and gynecologist 4.
General considerations include:
- 1. Vijayaraghavan GR, Levine D. Case 109: Meigs syndrome. Radiology. 2007;242 (3): 940-4. doi:10.1148/radiol.2423040775 - Pubmed citation
- 2. Chourmouzi D, Papadopoulou E, Drevelegas A. Magnetic resonance imaging findings in pseudo-Meigs' syndrome associated with a large uterine leiomyoma: a case report. J Med Case Reports. 2010;4 : 120. doi:10.1186/1752-1947-4-120 - Free text at pubmed - Pubmed citation
- 3. Nemeth AJ, Patel SK. Meigs syndrome revisited. J Thorac Imaging. 2003;18 (2): 100-3. J Thorac Imaging (link) - Pubmed citation
- 4. Meigs JV. Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome. Am. J. Obstet. Gynecol. 1954;67 (5): 962-85. - Pubmed citation
- 5. Bierman SM, Reuter KL, Hunter RE. Meigs syndrome and ovarian fibroma: CT findings. J Comput Assist Tomogr. 14 (5): 833-4. - Pubmed citation
- 6. Samanth KK, Black WC. Benign ovarian stromal tumors associated with free peritoneal fluid. Am. J. Obstet. Gynecol. 1970;107 (4): 538-45. - Pubmed citation
- 7. La fianza A, Alberici E. CT diagnosis of Pseudo-Meigs' syndrome. Clin Radiol. 2002;57 (4): 315-7. doi:10.1053/crad.2001.0845 - Pubmed citation
- 8. Mohammed SA, Kumar A. Meigs Syndrome. [Updated 2021 Jul 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559322/