Demons-Meigs syndrome

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. Other primary tumors include:

• ovarian fibrothecoma
• ovarian thecoma
• granulosa cell tumors of the ovary
• Brenner tumor: rare

Pathology

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.

Distribution

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  .

Differential diagnosis

General considerations include:

• malignant ascites and pleural effusion in the presence of an aggressive ovarian tumor
• pseudo-Meigs syndrome: benign reversible pleural effusion in the presence of a primary tumor other than solid ovarian tumors, e.g. broad ligament leiomyoma

Siehe auch:

• broad ligament leiomyoma
• Pseudo-Meigs-Syndrom

und weiter:

• ovarian fibrothecoma
• massive ovarian oedema