Presentation
Progressive abdominal swelling.
Patient Data
There is a well-circumscribed oval-shaped slightly hypodense (to muscle) solid mass in the right adnexium, suggestive of ovarian origin. This mass shows scanty and slow enhancement to contrast. It measures about 6.0 X 5.5 X 4.2 cm in its LS x AP x TS dimensions, with an estimated volume of 72.5 cm3. No calcification or cystic component is seen.
There are gross ascites, as well as right-sided moderate pleural collection. There is associated loss of volume and consolidative/atelectatic changes in the adjacent lung parenchyma.
Some tiny ring-like myometrial calcifications, suggestive of leiomyoma are noted.
Incidental left renal simple cortical cyst is also seen.
Case Discussion
The patient shows the classic presentation of Meigs syndrome, namely benign solid ovarian mass, gross ascites and pleural effusion. Although no histology is available to ascertain the presence of ovarian fibroma, the tumor is seen to be hypodense and shows scanty enhancement to contrast, similar to findings in ovarian fibroma.
Even, though Meigs syndrome is classically associated with ovarian fibroma, other benign ovarian conditions, as well as ovarian malignancies have also been reported. A possibility of "pseudo-Meigs syndrome" could be considered.
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