Presentation
Patient with no previous history of importance, she presents a clinical picture of two months of evolution consisting of weight loss associated with a sensation of mass in the pelvis.
Patient Data
Bilateral pleural effusions, larger on the left.
Liver of normal shape and size, with increased portal echogenicity. Gallbladder without lithiasis Pancreas and spleen without alterations. Kidneys of usual shape, size and location, good parenchymal sinus differentiation, without cavity dilatation or lithiasis.
At the level of the hypogastrium and mesogastrium appears a hypoechoic mass with fibrous tracts and small anechoic areas inside, avascular on the Doppler study.
Small uterus, no visualisation of the right ovary, enlarged left ovary with peripheral calcifications and a hypoechoic centre.
Presence of moderate ascites and bilateral pleural effusion.
Case Discussion
Meigs syndrome is characterised by a benign ovarian tumour, predominantly ovarian fibroma, associated with pleural effusion and ascites. The clinical picture resolves with tumour resection.
The syndrome may or may not present with CA-125 elevation (the patient in this case presented with elevated CA-125).
Differential diagnosis of pseudo-Meigs syndrome should be performed.
Freeze biopsy of giant ovarian tumour. Ovarian fibroma with myxoid degenerative changes.
The clinical case was also contributed by Dra. Diana Ayup Garcia, specialist in MGI 1st grade, specialist in Radiology 1st grade, assistant professor, Hospital Hermanos Ameijeiras, Cuba.
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