Meigs syndrome secondary to adult granulosa cell tumour with elevated CA125 levels: a case report

ABSTRACT

Background. Meigs syndrome is defined as an ovarian tumor combined with ascites and hydrothorax. The underlying pathophysiology of ascites and pleural effusion in Meigs syndrome is not determined; however, these conditions will resolve after the resection of the ovarian tumor. Meigs syndrome with CA125 elevation is a rare benign condition, mimicking advanced ovarian cancer.
Case presentation. We report the case of a 44-year-old woman who presented with severe dyspnea and distended abdomen. Her serum CA125 level was 948 IU/mL. Computed tomography scans revealed a large pelvic mass, ascites, and bilateral exudative pleural effusions. Considering the suspicion of ovarian cancer, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Accordingly, an adult granulosa cell tumor, stage IA, was confirmed. Ascites with pleural effusions completely resolved after surgery. Meigs syndrome was finally diagnosed based on spontaneous resolution of the accumulated fluids after the removal of the ovarian tumor. Further, the postoperative CA125 level dropped to the normal range. The patient has remained disease-free for 2 years and is receiving follow-up examinations regularly without adjuvant treatment.
Conclusions. Meigs syndrome with elevated CA125 may lead to misdiagnosis of advanced ovarian cancer. If there is no evidence of malignant cells on cytology of the pleural effusion or ascites, Meigs syndrome should be considered.