Giant struma ovarii with pseudo-Meigs’syndrome and raised cancer antigen-125 levels:A case report

BACKGROUND Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue,accounting for 1%to 3%of all ovarian teratomas and 0.3%to 1.0%of all ovarian tumors.Of which,struma ovarii with ascites and pleural effusion,called pseudo-Meigs’syndrome and raised cancer antigen-125levels(CA 125)is even rarer.CASE SUMMARY This paper reports the diagnosis and treatment of a patient of struma ovarii with pseudo-Meigs’syndrome,presenting with the clinical features of ovarian carcinoma:Complex pelvic mass,gross ascites,right pleural effusion and markedly elevated serum CA 125 levels.During the operation,a cystic-solid mass about 20cm×10 cm×5 cm in the right adnexa and a solid mass with the size of 3 cm×2cm×0.1 cm in the left ovary were observed.She underwent right adnexectomy and resection of the left ovarian mass and histopathology revealed a mature leftsided ovarian teratoma and struma ovarii of right adnexal mass.During 1-year follow-up,the patient recovered well,tumor markers and other indicators returned to normal.CONCLUSION The diagnosis and treatment process of this case suggests that the clinical symptoms of struma ovarii with pseudo-Meigs’syndrome are lack specificity,which is easily misdiagnosed.Clinicians should improve the understanding of this disease,enhance the awareness of early screening,and improve the level of diagnosis and treatment.

Clinical experience of Pseudo-Meigs' Syndrome due to colon cancer

We report a rare case of Pseudo-Meigs' Syndrome caused by ovarian metastasis from sigmoid colon cancer, which was accompanied by peritoneal dissemination. A 58-year-old female patient presented with massive right pleural effusion, ascites and a huge pelvic mass. Under the diagnosis of an advanced ovarian tumor, bilateral oophorectomy was performed and sigmoidectomy was also carried out after intraoperative diagnosis of peritoneal dissemination involving the sigmoid colon. How- ever, immunohistochemical staining revealed that the ovarian lesions were metastasis from the primary advanced colon cancer. Postoperatively, ascites and pleural effusion subsided, and the diagnosis of Pseudo-Meigs' Syndrome due to a metastatic ovarian tumor from colon cancer was determined. The patient is now undergoing a regimen of chemotherapy for colon cancer without recurrence of ascites or hydrothorax 10 mo after the surgery. Pseudo-Meigs' Syndrome due to a metastaticovarian tumor from colon cancer is rare but clinically important because long-term alleviation of symptoms can be achieved by surgical resection. This case report suggests that selected patients, even with peritoneal dissemination, may obtain palliation from surgical resection of metastatic ovarian tumors.

Abdominopelvic leiomyoma with large ascites:A case report and review of the literature

BACKGROUND Leiomyoma of the uterus is relatively common,but uterine leiomyoma of the greater omentum is rare.CASE SUMMARY Here,we report the case of a 22-year-old woman who presented with a 3 mo history of progressive abdominal distension and a hypervascular abdominopelvic mass.Due to a high serum concentration of CA125,the preoperative diagnosis was unclear.During surgery,5 L of ascites was removed.An 18.8 cm solid mass,which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum,was removed.The CA125 level was reduced postoperatively,and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus.CONCLUSION Uterine leiomyoma can share vessels with the greater omentum.This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the importance of imaging and laboratory examinations.