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Struma Ovarii Presented With Pseudo-Meigs’ Syndrome: A CaseReport and Review of The Literature

Yıl 2021, , 28 - 33, 16.12.2021
https://doi.org/10.29228/HMJ.6

Öz

Pseudo-Meigs' syndrome is a clinical condition characterized by ascites and pleural effusion, accompanied by pelvic tumors other than ovarian fibroma. Struma ovarii is a tumor that can lead to this syndrome and is a variant of mature cystic teratoma. When presented with Pseudo-Meigs’ syndrome, it is important because it can be confused with malignant ovarian tumors, peritonitis carcinomatosis, and malignant pleural effusion. Another important factor is the disappearance of the ascites and pleural effusion and rapid regression of symptoms after the removal of the tumor. Accompanying ascites and high CA-125 values with struma ovarii ​​is very rarely seen.

In the present report, a 53-year-old patient with histopathological diagnosis of struma ovarii who had been operated because of presumptive diagnosis of ovarian malignancy and whose symptoms and complaints rapidly resolved during the postoperative period was presented.

Pseudo-Meigs’ syndrome should be considered among differential diagnoses in the presence of CA125 elevation, ovarian mass, ascites, pleural effusion in postmenopausal period. In addition, Pseudo-Meigs’ syndrome, though rarely, should be considered among differential diagnoses in patients who have not yet lost their fertility potential but whose cytological examination yielded negative results in terms of malignancy, especially in the presence of unexplained ascites and pleural effusion.

Kaynakça

  • Md Nor NB, Kusumoto T, Inoue S, Nakamura K, Seki N, Hongo A, et al. Three cases of struma ovarii underwent laparoscopic surgery with definite preoperative diagnosis. Acta Med Okayama 2013; 67:191–195.
  • Loizzi V, Cormio G, Resta L, Fattizzi N, Vicino M, Selvaggi L Pseudo-Meigs syndrome and elevated CA125 associated with struma ovarii. Gynecol Oncol 2005;97: 282-284. doi:10.1016/j.ygyno.2004.12.040
  • Obeidat R, Perren TJ, Saidi SA, Struma Ovarii Associated with Pseudo-Meigs' Syndrome and Elevated Serum CA 125: A Case Report and Literature Review , Gynecol Obstet 2012, 2:4. DOI: 10.4172/2161-0932.1000129
  • Szyfelbein WM, Young RH, Scully RE Struma ovarii simulating ovarian tumors of other types. A report of 30 cases. Am J Surg Pathol .1995; 19: 21-29. DOI:10.1097/00000478-199501000-00003
  • Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS. Clinical characteristics of struma ovarii. J Gynecol Oncol.2008; 19: 135-138. DOI:10.3802/jgo.2008.19.2.135
  • Jiang W, Lu X, Zhu ZL, Liu XS, Xu CJ Struma ovarii associated with pseudo-Meigs' syndrome and elevated serum CA 125: a case report and review of the literature. J Ovarian Res.2010;29; 3- 18. doi: 10.1186/1757-2215-3-18.
  • Amr SS, Hassan AA. Struma ovarii with pseudo-Meigs' syndrome: report of a case and review of the literature. Eur J Obstet Gynecol Reprod Biol. 1994; 55: 205-208. DOI:10.1016/0028-2243(94)90039-6
  • Samanth KK, Black WC 3rd Benign ovarian stromal tumors associated with free peritoneal fluid. Am J Obstet Gynecol. 1970; 107: 538-545. DOI:10.1016/s0002-9378(16)33939-4
  • Meigs JV. Fibroma of the ovary with ascites and hydrothorax; Meigs’ syndrome. Am J Obstet Gynecol.1954; 67: 962-985. DOI:10.1016/0002-9378(54)90258-6
  • Chen A, Ho YS, Tu YC, Tang HS, Cheng TC. Diaphragmatic defect as a cause of massive hydrothorax in cirrhosis of liver. J Clin Gastroenterol. 1988; 10: 663-666. DOI:10.1097/00004836-198812000-00019
  • Jung SI, Kim YJ, Lee MW, Jeon HJ, Choi JS, Moon MH. Struma ovarii: CT findings. Abdom Imaging.2008;33: 740-743. doi: 10.1007/s00261-008-9362-1.
  • Kebapci M, Aslan O, Kaya T, Yalcin OT, Ozalp S. Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features. Eur Radiol. 2002; 12: 127-129. DOI:10.1007/s00330-002-1464-5
  • Mui MP, Tam KF, Tam FK, Ngan HY. Coexistence of struma ovarii with marked ascites and elevated CA-125 levels: Case report and literature review. Arch Gynecol Obstet. 2009; 279:753–757. doi: 10.1007/s00404-008-0794-1.
  • Mitrou S, Manek S, Kehoe S: Cystic struma ovarii presenting as pseudoMeigs’ syndrome with elevated CA125 levels. A case report and review of the literature. Int J Gynecol Cancer 2008, 18:372-375. doi: 10.1111/j.1525-1438.2007.00998.x.
  • Surekha Yadav, Reena Tomar, *Nidhi Verma, Nita Khurana, Rewa Triathi. Struma Ovarii with Pseudo-Meigs’ Syndrome and Raised Cancer Antigen-125 Levels Masquerading as an Ovarian Carcinoma Sultan Qaboos University. Med J, 2017, Vol. 17, Iss. 2, pp. e229–233, Epub. 20 Jun 17 doi: 10.18295/squmj.2016.17.02.017
  • Mehrnoosh Pauls, Heather MacKenzie, Ravi Ramjeesingh. Hydropic leiomyoma presenting as a rare condition of pseudo-Meigs syndrome: literature review and a case of a pseudo-Meigs syndrome mimicking ovarian carcinoma with elevated CA125. BMJ Case Rep. 2019;11:e226454. doi:10.1136/bcr-2018-226454

Pseudo-Meigs Sendromu ile Başvuran Struma Ovarii: Bir Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Yıl 2021, , 28 - 33, 16.12.2021
https://doi.org/10.29228/HMJ.6

Öz

Pseudo-Meigs sendromu, over fibromu dışındaki pelvik tümörlerin eşlik ettiği asites ve plevral efüzyon ile karakterize klinik bir durumdur. Struma ovarii, bu sendroma yol açabilen bir tümördür ve matür kistik teratomun bir çeşididir. Pseudo-Meigs sendromu ile sunulduğunda malign over tümörleri, peritonit karsinomatozis ve malign plevral efüzyon ile karıştırılabilmesi nedeniyle önemlidir. Bir diğer önemli faktör ise tümörün çıkarılmasından sonra asites ve plevral efüzyonun kaybolması ve semptomların hızla gerilemesidir. Eşlik eden asites ve yüksek CA-125 değerleri ile struma ovarii çok nadir görülür.
Bu yazıda over malignitesi ön tanısı ile opere edilen ve postoperatif dönemde semptom ve şikayetleri hızla düzelen, histopatolojik struma ovarii tanısıyla opere edilen 53 yaşında bir hasta sunuldu.
Postmenopozal dönemde CA125 yüksekliği, over kitlesi, asit, plevral efüzyon varlığında yalancı Meigs sendromu ayırıcı tanılar arasında düşünülmelidir. Ayrıca fertilite potansiyelini henüz kaybetmemiş ancak sitolojik incelemesi malignite açısından olumsuz sonuç veren hastalarda, özellikle açıklanamayan asit ve plevral efüzyon varlığında nadiren de olsa Pseudo-Meigs sendromu ayırıcı tanılar arasında düşünülmelidir.

Kaynakça

  • Md Nor NB, Kusumoto T, Inoue S, Nakamura K, Seki N, Hongo A, et al. Three cases of struma ovarii underwent laparoscopic surgery with definite preoperative diagnosis. Acta Med Okayama 2013; 67:191–195.
  • Loizzi V, Cormio G, Resta L, Fattizzi N, Vicino M, Selvaggi L Pseudo-Meigs syndrome and elevated CA125 associated with struma ovarii. Gynecol Oncol 2005;97: 282-284. doi:10.1016/j.ygyno.2004.12.040
  • Obeidat R, Perren TJ, Saidi SA, Struma Ovarii Associated with Pseudo-Meigs' Syndrome and Elevated Serum CA 125: A Case Report and Literature Review , Gynecol Obstet 2012, 2:4. DOI: 10.4172/2161-0932.1000129
  • Szyfelbein WM, Young RH, Scully RE Struma ovarii simulating ovarian tumors of other types. A report of 30 cases. Am J Surg Pathol .1995; 19: 21-29. DOI:10.1097/00000478-199501000-00003
  • Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS. Clinical characteristics of struma ovarii. J Gynecol Oncol.2008; 19: 135-138. DOI:10.3802/jgo.2008.19.2.135
  • Jiang W, Lu X, Zhu ZL, Liu XS, Xu CJ Struma ovarii associated with pseudo-Meigs' syndrome and elevated serum CA 125: a case report and review of the literature. J Ovarian Res.2010;29; 3- 18. doi: 10.1186/1757-2215-3-18.
  • Amr SS, Hassan AA. Struma ovarii with pseudo-Meigs' syndrome: report of a case and review of the literature. Eur J Obstet Gynecol Reprod Biol. 1994; 55: 205-208. DOI:10.1016/0028-2243(94)90039-6
  • Samanth KK, Black WC 3rd Benign ovarian stromal tumors associated with free peritoneal fluid. Am J Obstet Gynecol. 1970; 107: 538-545. DOI:10.1016/s0002-9378(16)33939-4
  • Meigs JV. Fibroma of the ovary with ascites and hydrothorax; Meigs’ syndrome. Am J Obstet Gynecol.1954; 67: 962-985. DOI:10.1016/0002-9378(54)90258-6
  • Chen A, Ho YS, Tu YC, Tang HS, Cheng TC. Diaphragmatic defect as a cause of massive hydrothorax in cirrhosis of liver. J Clin Gastroenterol. 1988; 10: 663-666. DOI:10.1097/00004836-198812000-00019
  • Jung SI, Kim YJ, Lee MW, Jeon HJ, Choi JS, Moon MH. Struma ovarii: CT findings. Abdom Imaging.2008;33: 740-743. doi: 10.1007/s00261-008-9362-1.
  • Kebapci M, Aslan O, Kaya T, Yalcin OT, Ozalp S. Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features. Eur Radiol. 2002; 12: 127-129. DOI:10.1007/s00330-002-1464-5
  • Mui MP, Tam KF, Tam FK, Ngan HY. Coexistence of struma ovarii with marked ascites and elevated CA-125 levels: Case report and literature review. Arch Gynecol Obstet. 2009; 279:753–757. doi: 10.1007/s00404-008-0794-1.
  • Mitrou S, Manek S, Kehoe S: Cystic struma ovarii presenting as pseudoMeigs’ syndrome with elevated CA125 levels. A case report and review of the literature. Int J Gynecol Cancer 2008, 18:372-375. doi: 10.1111/j.1525-1438.2007.00998.x.
  • Surekha Yadav, Reena Tomar, *Nidhi Verma, Nita Khurana, Rewa Triathi. Struma Ovarii with Pseudo-Meigs’ Syndrome and Raised Cancer Antigen-125 Levels Masquerading as an Ovarian Carcinoma Sultan Qaboos University. Med J, 2017, Vol. 17, Iss. 2, pp. e229–233, Epub. 20 Jun 17 doi: 10.18295/squmj.2016.17.02.017
  • Mehrnoosh Pauls, Heather MacKenzie, Ravi Ramjeesingh. Hydropic leiomyoma presenting as a rare condition of pseudo-Meigs syndrome: literature review and a case of a pseudo-Meigs syndrome mimicking ovarian carcinoma with elevated CA125. BMJ Case Rep. 2019;11:e226454. doi:10.1136/bcr-2018-226454
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Olgu Sunumu/Olgu Serisi
Yazarlar

Yakup Baykuş 0000-0001-5730-8477

Rulin Deniz 0000-0002-7306-8212

Muhammet Bora Uzuner 0000-0001-6557-3086

Alihan Tığlı Bu kişi benim 0000-0002-9404-4869

Nazlı Şener Bu kişi benim 0000-0002-3931-9452

Yayımlanma Tarihi 16 Aralık 2021
Gönderilme Tarihi 17 Kasım 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Baykuş Y, Deniz R, Uzuner MB, Tığlı A, Şener N. Struma Ovarii Presented With Pseudo-Meigs’ Syndrome: A CaseReport and Review of The Literature. HTD / HMJ. 2021;1(1):28-33.

e-ISSN: 2791-9935