Meig’s Syndrome

Epidemiology

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Etiology

Etiology of Meig’s Syndrome:

  • Ovarian Fibroma:
  • Ovarian Fibroma-Like Tumor (Brenner Tumor, Thecoma, Granulosa Cell Tumor):

Etiology of Atypical Meig’s (Pseudo-Meig’s) Syndrome:

  • Ovarian Cyst:
  • Bilateral Ovarian Stromal Hyperplasia:
  • Benign cystic teratomas
  • Leiomyomas
  • Fibromyomas
  • Hemangiomas
  • Cystadenomas
  • Uterine leiomyomas
  • Papillomas of the fallopian tubes

Physiology

  • Pleural effusion probably occurs due to movement of fluid into the pleural space through rents in the diaphragm (or lypmhatic channels), similar to the mechanism of hepatic hydrothorax

Diagnosis

  • Pleural Fluid: usually exudative (but can be transudative in some cases)
    • Cholesterol: elevated >55-60 mg/dL (seen in all exudates)
    • Pleural: Serum Cholesterol Ratio: elevated (seen in all exudates)
    • Ascites and pleural fluid almost always have the same chemical characteristics
    • Color: straw-colored, serosanguinous, or bloody
    • Side: unilateral (usually right-sided) or bilateral
    • Size: range from small-massive
  • CXR/Chest CT Patterns
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  • Pelvic Ultrasound: aids in diagnosis of ovarian fibroma
  • CA 125 Level: although ovarian cancer can cause elevations, several benign ovarian tumors (which can cause Meig s Syndrome) can also have elevated CA 125 levels

Clinical

  • Ascites:
  • Pleural Effusion (see [[Pleural Effusion-Exudate]] and [[Pleural Effusion-Transudate]])
    • usually right-sided (but can be bilateral in some cases)
    • Meigs Syndrome: original description was that of a transudate -> however, subsequent reports note that these are typically exudates

Treatment

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References

  • Meigs FV. Fibroma of the ovary with ascites and hydrotho- rax: Meig’s syndrome. Am J Obstet Gynecol 1954; 67: 962–987