Meigs syndrome: a case report and literature review

Abstract

Introduction: Meigs syndrome is defined by the presence of an ovarian benign tumor, ascites, and pleural effusion. The restoration of normal conditions following the removal of the ovarian mass is typical. Although an increase in CA 125 has been reported in association with Meigs syndrome, a level above 1000 IU/mL is unusual, and there is no clear association between patients’ or tumor/cancer characteristics and CA 125 increment to the best of our knowledge.
Materials and methods: We conducted a review of Meigs syndrome cases associated with high CA 125 levels and then divided and compared all cases found in the literature and the one described in the text, taking into account the increase of CA 125 = 1000 IU/mL, to identify any possible factor influencing the CA 125 increase.
Results: A 55-year-old woman with Meigs syndrome (hydrothorax, ovarian fibroma, and ascites) presented CA 125 of 1713 IU/mL. In our review, we found 43 articles that collected 55 cases of Meigs syndrome with an increase in CA 125 of 25% or more than 1000 IU/mL. Considering two groups, divided considering the CA 125 value of 1000 IU/mL, we found that the presence of bilateral masses and ascites over 2 L represented independent risk factors for high elevation of CA 125.
Conclusion: The presence of bilateral mass and an increase in ascites were associated with an increase in CA 125 of 1000 IU/mL, which could be useful in maintaining a benign lesion hypothesis even if the definitive diagnosis could not be made until after surgery, at histological evaluation.