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Abstract
Pseudo-Meigs' syndrome is a syndrome that includes hydrothorax and ascites secondary to ovarian tumors other than solid benign fibroma. In this report, we present the case of a 29-years-old female who complained of abdominal distension with peripheral edema during her third trimester. Two solid masses of 15 cm dimension in the left abdomen and 7 cm dimension in the right abdomen were detected by ultrasound and chest X-ray revealed right pleural effusion. Magnetic resonance imaging (MRI) confirmed the ovarian masses and ascites. As the patient had regular uterine contractions, we decided to perform emergency cesarean section because of previous cesarean section history. A laparotomy was performed and pathologists confirmed the presence of a metastatic adenocarcinoma. Four days following the surgery, gastroduodenoscopy revealed a huge ulcerofungating mass was visible in greater curvature of stomach. The final diagnosis was metastatic adenocarcinoma from gastric cancer. Although pseudo-Meigs' syndrome is very rare, it should be carefully considered when evaluating female complaining with ascites in ovarian tumor.
Figures and Tables
Fig. 1
Trans abdominal ultrasonography shows two huge solid abdominal masses with large amount of ascites.
Fig. 2
Chest X-ray. (A) Chest X-ray on her first hospital visits shows right pleural effusion and subsegmental atelectasis in both basal lungs. (B) After the cesarean section and exploratory laparotomy, chest X-ray shows increased amount of right pleural effusion.
Fig. 3
Gross appearance of the resected bilateral ovarian tumor. (A) A lump of soft mass (11.5×7×3.5 cm, 86 g) in the left ovary and involved fallopian tube. Its surface is yellowish white, solid, and granular with multifocal hemorrhage. (B) Multiple nodules in the right ovary, mesosalpinx and mesovarium with invasion to fallopian tube.
Fig. 4
Gastroduodenoscopy and Biopsy finding. (A) Four days following the surgery, gastroduodenoscopy reveals huge ulcerofungating mass on greater curvature (posterior lower body of the stomach) and edge of ulcer is irregular and unclear. (B) Microscopic examination of the specimen shows that it is poorly differentiated and the mucus remains inside the tumor cell, it pushes the nucleus at the periphery (H&E stain, ×200).
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