Introduction

Ovarian tumors often present diagnostic challenges, especially when their symptoms mimic malignant diseases. A recently documented case highlights a rare manifestationMeigs syndrome, characterized by a benign ovarian tumor with accompanying ascites and hydrothorax. This intriguing case broadens our understanding of tumor behavior and diagnostic pitfalls.
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Understanding Meigs Syndrome A Rare Clinical Entity

Meigs syndrome refers to the triad of an ovarian fibroma, ascites, and hydrothorax. Although typically benign, its clinical and radiological presentation often mimics ovarian malignancy, compelling radical surgical intervention.

• Prevalence: Occurs in only 0.25% of ovarian tumors.
• Typical Patients: Predominantly affects women aged 40-70 years.
• Clinical Features: Ascites, right-sided pleural effusion, and a solid ovarian mass.

Case Study Overview

A 69-year-old postmenopausal woman presented with dyspnea, weight loss, abdominal pain, and a mobile pelvic mass. Diagnostic imaging revealed a large right-sided ovarian mass with ascites and pleural effusion. Tumor markers (CA 125 and HE-4) were markedly elevated, and the ROMA score suggested malignancy.

Read the full study at https://doi.org/10.29328/journal.cjog.1001120.

Diagnostic Challenges and Surgical Approach

Given the alarming clinical context:

• Preoperative Findings: Massive ascites, pleural effusion, high tumor markers.
• Intervention: A comprehensive surgical procedure including hysterectomy, right adnexectomy, omentectomy, appendectomy, and biopsies.
• Histological Confirmation: Revealed a benign ovarian fibroma, establishing the diagnosis of Meigs syndrome.

Broader Medical Implications

The American College of Obstetricians and Gynecologists (ACOG) emphasizes the need for differential diagnosis in ovarian masses, particularly when imaging and tumor markers create ambiguity. Proper histological evaluation remains crucial in avoiding unnecessary radical surgeries.

Importance of Histopathological Evaluation

Despite clinical suspicion leaning heavily towards malignancy, only tissue diagnosis confirmed the benign nature of the mass. This case reiterates a vital lesson in gynecologic oncology: “Ascites and pleural effusions do not equate to cancer without histological evidence.”

Further Reading and Resources

• Explore more clinical gynecology cases at https://www.obstetricgynecoljournal.com
• Learn about Ovarian Tumor Management
• Related article: Case Studies on Benign Ovarian Masses

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