Meigs' syndrome

Introduction

Fibromyoma of the ovaries, ascites, pleural effusion.

Distinguish from primary cranial dystonia (Meige's syndrome).

Etiology

• associated with benign edematous ovarian fibromas > 10 cm in size

Epidemiology

• associated with < 1% of ovarian fibromas
• associated with 0.004% of ovarian tumors

Pathology

• may result from torsion on stalk of large fibroma with backflow transudation of fluid back into the peritoneal cavity & eventually pleural cavity

Clinical manifestations

• may be asymptomatic
• pelvic mass
• intermittent pelvic pain
• abdominal pain
• bloating
• signs of ascites
• signs of pleural effusion

Laboratory

• complete blood count (rule out inflammation)
• CA-125, hcG, AFP, CEA
• chem-7
• liver function tests

Radiology

• pelvic ultrasound
• chest X-ray

Differential diagnosis

• ovarian or uterine malignancy
• non-malignant disorder
  • portal vein thrombosis
  • obstruction of inferior vena cava
  • obstruction of thoracic duct
  • tuberculosis
  • amyloidosis
  • pancreatitis
  • congestive heart failure
  • connective tissue disease
  • pancreatitis
  • cirrhosis

Management

• laparoscopic TAHBSO
• prognosis: complete cure expected

More general terms

• syndrome

Additional terms

• primary cranial dystonia; idiopathic tosional dystonia