A Case of Unexplained Pleural Effusion Diagnosed as Meigs' Syndrome

Abstract

Meigs' syndrome (MS) is defined as a benign ovarian tumor with pleural effusion and ascites, which, resolve after its removal. The pathogenesis of ascites and pleural effusion in MS is unknown. A 64-year-old woman with a history of uterine fibroid was admitted owing to dyspnea over 1 month. A chest radiograph showed right hydrothorax. Carbohydrate antigen 125 (CA-125) level was 645 U/mL. Computed tomography of chest, abdominal, and pelvis showed hydrothorax in the right thoracic cavity and atelectasis of the right lower lobe, a tumor, 14 cm in diameter, and ascites in the pelvis. Despite chest drainage for hydrothorax, the amount of pleural effusion was over 300 ml/days every day. Pleural fluid was a lymphocyte-predominant exudate. The bacterial mycobacterial cultures of the pleural fluid were negative. Cytological examination of the pleural fluid showed no malignancy. As the combination of pleural effusion, ascites, and ovarian tumor was suggestive of MS, the patient was referred to the Department of Gynecology. She underwent total hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination of the resected tumor confirmed fibrothecoma. Thus, it is important to consider the possibility of MS in female patients with unexplained pleural effusion and an ovarian tumor.

Keywords

• meigs' syndrome
• pleural effusion
• ca-125
• ovarian fibrothecoma