Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report

Abstract

Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated cancer antigen 125 (CA-125) in Meigs' syndrome is an unusual clinical condition reported in few cases. We report here on a 61-year-old woman who presented with dyspnea; in imaging assessment, a heterogeneous pelvic mass measuring 12 × 11 cm with ascitic fluid was reported. Pleural effusion was detected on Chest X-ray. Aspiration of pleural fluid showed no evidence of malignancy. CA-125 level was 347 IU/mL. The patient underwent laparotomy during which a mass measuring 12 × 11 cm was detected in her left adnexa. Histology showed ovarian thecoma. The mass was resected, and, after that, the symptoms disappeared and CA-125 level reached 19 IU/mL. The patient had experienced no problem after 12 months of follow up. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA-125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.

Keywords: CA-125; Meigs syndrome; Pleural effusion.

Fig. 1. A chest X-ray revealed the presence of a massive right sided pleural effusion.

Fig. 2. Abdominopelvic computed tomography scan revealed a solid heterogeneous mass in pelvic midline with ascites.

Fig. 3. The tumor cells have bland, oval to spindle shaped nuclei and abundant, pale vacuolated cytoplasm. Individual tumor cells are invested by thin reticulin fibers (H&E × 400).