Endocrine Abstracts

Introduction: Meigs’ syndrome is defined as the presence of a benign ovarian tumour (fibroma), in association with ascites and hydrothorax. The characteristic feature of this condition is the resolution of the effusions once the tumour is surgically removed.

Case report: A 63 year-old female patient was admitted to the Surgery Clinic with metroragia, abdominal distention, and a recent history of minor breath shortness. Pulmonary clinical examination showed all the signs of right pleural effusion, which was also confirmed by the chest X-ray. The abdominal examination revealed a round irregular mass arising from the right pelvic cavity. Abdominal ultrasound showed a large pelvic mass (23 cm in diameter) more on the right pelvic cavity, a polyfibromatous uterus, and a small quantity of ascites. A complete blood count was carried out, with normal results. Surgical intervention was decided and the laparotomy confirmed a large pelvic mass which was part of the left ovary, dislodged in the right side of the peritoneal cavity. Also, 100 ml of ascitic fluid and a polyfibromatous uterus were found. The ovarian mass was removed and also a hysterectomy with bilateral adnexectomy was performed. The macroscopic appearance: giant polynodular tumoral mass (23 cm in diameter), with compact structure, microcysts, and haemorrhagic areas. No residual ovarian tissue was observed in the subcapsular portion of the tumour. Microscopically, a compact tissue, consisting of pleomorphic fusiform cells, and discrete mitotic activity (less than 3 divisions/10 fields) was described. The cells were arranged in fascicles, with hyaline and myxomatous areas. Dilated vessels with thrombotic material were noted. The absence of malignancy of the tumour and of the ascitic and pleural effusions was confirmed by cytomorphologic study. In conclusion, the histopathological examination demonstrated an ovarian tumour with a fibroma aspect. Postoperative evolution was favorable and the patient was discharged after 12 days. The controll chest X-ray revealed the resolution of the hydrothorax.

Conclusion: Even though Meigs’ syndrome mimics an aggressive malignant ovarian tumour, in the presence of pleural and peritoneal effusions, after surgical removal of the tumour the patient has a good prognosis and the life expectancy is similar to normal healthy population, even if recurrence was also reported.