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Ovarian Mass, Pleural Effusion, and Ascites: Revisiting Meigs Syndrome

Riker, David MD, FCCP; Goba, Daniel MD

Journal of Bronchology & Interventional Pulmonology: January 2013 - Volume 20 - Issue 1 - p 48–51
doi: 10.1097/LBR.0b013e31827ccb35
Case Reports

Summary: The triad of pleural effusion, ascites, and benign ovarian fibroma is rare. Often, the ovarian mass is accompanied by elevated cancer antigen-125, both in serum and in pleural and peritoneal fluid. When benign ovarian fibroma is associated with ascites and/or pleural effusion it is termed Meigs syndrome. Meigs syndrome, however, is a diagnosis of exclusion only after ovarian carcinoma is ruled out. The presentation of symptoms and radiographic findings mimics that of metastatic ovarian cancer, creating a significant clinical challenge. We report a case of a patient with recurrent pleural effusions and an ovarian mass, with the outside hospital pleural fluid cytology report describing ovarian cancer. Although initially suspected to have metastatic ovarian cancer, subsequent workup of the patient’s pleural and peritoneal fluid revealed no carcinoma. Surgical biopsy of the ovarian mass showed the presence of a benign tumor (fibroma). Postovarian mass resection, the patient showed resolution of pleural and peritoneal effusions. We describe our case in detail and review the literature on Meigs syndrome.

Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Diego, CA

Disclosure: There is no conflict of interest or other disclosures.

Reprints: Daniel Goba, MD, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California, 200W Arbor Dr, MC 8380, San Diego, CA 92103-8380 (e-mail: dgoba@ucsd.edu).

Received August 31, 2012

Accepted September 25, 2012

© 2013 Lippincott Williams & Wilkins, Inc.