eMedicine Specialties > Obstetrics and Gynecology > Gynecologic Oncology

Meigs Syndrome: Treatment & Medication

Author: Klaus-Dieter Lessnau, MD, FCCP, Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital
Coauthor(s): Rajeshwari Chavda, MD, Consulting Staff, Emergency Care Group of Northwest; Ayesha Akhter, MD, Consulting Staff, Department of Internal Medicine, Columbia Tech Center, Vancouver Clinic; Mir Omar Ali, MD, Fellow, Department of Pulmonary Medicine, Lenox Hill Hospital, New York University; Lalit K Kanaparthi, MD, Fellow in Pulmonary Medicine, Lenox Hill Hospital
Contributor Information and Disclosures

Updated: Oct 9, 2008

Treatment

Medical Care

Medical care of patients with Meigs syndrome is intended to provide symptomatic relief of ascites and pleural effusion by means of therapeutic paracentesis and thoracentesis.

Surgical Care

  • Exploratory laparotomy with surgical staging is the treatment of choice.
    • Perform a frozen section of the ovarian mass during exploratory laparotomy. If the frozen section is consistent with benign tumor, conservative surgery (salpingo-oophorectomy or oophorectomy) is appropriate.
    • Findings of lymph node biopsies and omentum and pelvic washings are negative for malignancy if these procedures are performed during surgery.
  • In women of reproductive age, perform unilateral salpingo-oophorectomy.
  • In postmenopausal women, options include bilateral salpingo-oophorectomy with total hysterectomy and unilateral or occasionally bilateral salpingo-oophorectomy.
  • In prepubertal girls, options include wedge resection of ovary and unilateral salpingo-oophorectomy.
  • The cure rate after either type of surgery is high and recurrence is rare.

Consultations

Consult with a gynecologic surgeon for surgical management of the patient.

Activity

Patients can maintain activities as tolerated.

More on Meigs Syndrome

Overview: Meigs Syndrome
Differential Diagnoses & Workup: Meigs Syndrome
Treatment & Medication: Meigs Syndrome
Follow-up: Meigs Syndrome
References
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References

  1. Meigs JV, Cass JW. Fibroma of the ovary with ascites and hydrothorax: with a report of seven cases. Am J Obstet Gynecol. 1937;33:249-267.

  2. Dunn JS Jr, Anderson CD, Method MW. Hydropic degenerating leiomyoma presenting as pseudo-Meigs syndrome with elevated CA 125. Obstet Gynecol. Oct 1998;92(4 Pt 2):648-9. [Medline].

  3. Schmitt R, Weichert W, Schneider W, Luft FC, Kettritz R. Pseudo-pseudo Meigs' syndrome. Lancet. Nov 5 2005;366(9497):1672. [Medline].

  4. Samanth KK, Black WC. Benign ovarian stromal tumors associated with free peritoneal fluid. Am J Obstet Gynecol. Jun 15 1970;107(4):538-45. [Medline].

  5. Loizzi V, Cormio G, Resta L, Fattizzi N, Vicino M, Selvaggi L. Pseudo-Meigs syndrome and elevated CA125 associated with struma ovarii. Gynecol Oncol. Apr 2005;97(1):282-4. [Medline].

  6. Zannoni GF, Gallotta V, Legge F, Tarquini E, Scambia G, Ferrandina G. Pseudo-Meigs' syndrome associated with malignant struma ovarii: a case report. Gynecol Oncol. Jul 2004;94(1):226-8. [Medline].

  7. Tjalma WA. Ascites, pleural effusion, and CA 125 elevation in an SLE patient, either a Tjalma syndrome or, due to the migrated Filshie clips, a pseudo-Meigs syndrome. Gynecol Oncol. Apr 2005;97(1):288-91. [Medline].

  8. Jones OW, Surwit EA. Meigs syndrome and elevated CA 125. Obstet Gynecol. Mar 1989;73(3 Pt 2):520-1. [Medline].

  9. Lin JY, Angel C, Sickel JZ. Meigs syndrome with elevated serum CA 125. Obstet Gynecol. Sep 1992;80(3 Pt 2):563-6. [Medline].

  10. Agaba EI, Ekwempu CC, Ugoya SO, Echejoh GO. Meigs' syndrome presenting as haemorrhagic pleural effusion. West Afr J Med. Jul-Sep 2007;26(3):253-5. [Medline].

  11. Aoshima M, Tanaka H, Takahashi M, Nakamura K, Makino I. Meigs' syndrome due to Brenner tumor mimicking lupus peritonitis in a patient with systemic lupus erythematosus. Am J Gastroenterol. Apr 1995;90(4):657-8. [Medline].

  12. Carson SA, Mazur MT. Atypical endometrioid cystadenofibroma with Meigs' syndrome: ultrastructure and S-phase fraction. Cancer. Feb 1 1982;49(3):472-9. [Medline].

  13. Cissé CT, Ngom PM, Sangare M, Ndong M, Moreau JC. [Ovarian fibroma associated with Demons-Meigs syndrome and elevated CA 125]. J Gynecol Obstet Biol Reprod (Paris). May 2004;33(3):251-4. [Medline].

  14. Lacson AG, Alrabeeah A, Gillis DA, Salisbury S, Grantmyre EB. Secondary massive ovarian edema with Meig's syndrome. Am J Clin Pathol. May 1989;91(5):597-603. [Medline].

  15. Mitrou S, Manek S, Kehoe S. Cystic struma ovarii presenting as pseudo-Meigs' syndrome with elevated CA125 levels. A case report and review of the literature. Int J Gynecol Cancer. Mar-Apr 2008;18(2):372-5. [Medline].

  16. Morán-Mendoza A, Alvarado-Luna G, Calderillo-Ruiz G, Serrano-Olvera A, López-Graniel CM, Gallardo-Rincón D. Elevated CA125 level associated with Meigs' syndrome: case report and review of the literature. Int J Gynecol Cancer. Jan-Feb 2006;16 Suppl 1:315-8. [Medline].

  17. Peparini N, Di Matteo FM, Silvestri A, Caronna R, Chirletti P. Abdominal hypertension in Meigs' syndrome. Eur J Surg Oncol. Sep 29 2007;[Medline].

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Further Reading

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Keywords

Meigs syndrome, Meigs-Salmon syndrome, pseudo-Meigs syndrome, pseudo-pseudo Meigs syndrome, fibromyoma, hydroperitoneum, hydrothorax, atypical Meigs, benign ovarian tumor, ovarian cancer, ascites, pleural effusion, ovarian fibromas, pelvic tumor, pelvic mass, thecoma, cystadenoma, granulosa cell tumor, teratomas, struma ovarii

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Contributor Information and Disclosures

Author

Klaus-Dieter Lessnau, MD, FCCP, Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital
Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Artificial Internal Organs, American Thoracic Society, Physicians for Social Responsibility, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Rajeshwari Chavda, MD, Consulting Staff, Emergency Care Group of Northwest
Disclosure: Nothing to disclose.

Ayesha Akhter, MD, Consulting Staff, Department of Internal Medicine, Columbia Tech Center, Vancouver Clinic
Disclosure: Nothing to disclose.

Mir Omar Ali, MD, Fellow, Department of Pulmonary Medicine, Lenox Hill Hospital, New York University
Mir Omar Ali, MD is a member of the following medical societies: American College of Physicians and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Lalit K Kanaparthi, MD, Fellow in Pulmonary Medicine, Lenox Hill Hospital
Lalit K Kanaparthi, MD is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey B Garris, MD, Chief, Assistant Professor, Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Tulane University School of Medicine
Jeffrey B Garris, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, American Urological Association, Association of Professors of Gynecology and Obstetrics, Louisiana State Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Carl V Smith, MD, The Distinguished Chris J and Marie A Olson Chair of Obstetrics and Gynecology, Professor, Department of Obstetrics and Gynecology, University of Nebraska Medical Center
Carl V Smith, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, Arkansas Medical Society, Association of Professors of Gynecology and Obstetrics, Central Association of Obstetricians and Gynecologists, Council of University Chairs of Obstetrics and Gynecology, Nebraska Medical Association, and Society for Maternal-Fetal Medicine
Disclosure: Nothing to disclose.

 
 
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