IMAGE OF THE MONTH

Meigs’ Syndrome
David J. Quinlan, BSc, MBBCH, FRCOG, FRCSC
Victoria, BC

A 50-year-old woman presented with severe dyspnea and

abdominal distension. A right-sided pleural effusion
(Figure 1) was drained with no malignant cells or signs of
infection in the fluid. A bronchoscopy was negative. Pelvic
ultrasound showed a multifibroid uterus with a 10 cm solid
mass (thought to be a pedunculated fibroid) and moderate
free fluid. MRI also showed a multifibroid uterus with a
10 cm solid mass in the right adnexa. The serum CA 125
level was 992.1 kU/L.
Meigs’ syndrome is a triad of benign ovarian tumour
(fibroma), ascites, and pleural effusion, which resolves
after removal of the tumour.1 Meigs’ syndrome with an
elevated CA 125 has been previously reported.2
Consent to publish these images has been obtained from
the patient.
REFERENCES

A chest tube was placed and the patient underwent a 1. Meigs JV, Cass JW. Fibroma of the ovary with ascites and hydrothorax: with a
laparotomy with hysterectomy and bilateral salpingo­ report of seven cases. Am J Obstet Gynecol 1937;33:249–67.
oophorectomy. Intraoperative frozen section of the right 2. Timmerman D, Moerman P, Vergote I. Meigs’ syndrome with elevated CA
ovary was benign. The patient made an uneventful recovery. 125: two cases and review of the literature. Gynecol Oncol 1995;59:405–8.

The final pathology of the right ovary (Figure 2) was a

benign fibroma weighing 467 grams. J Obstet Gynaecol Can 2012;34(4):311

Figure 1. Figure 2.

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