An Unusual Bilateral Presentation of Meigs' Syndrome in a Postmenopausal Woman: A Case Report.
Sherin Mohammed Refaey Farag, Mazed Mohamed Labib Ghonemy Ibrahim, Ahmed Mohamed Fahmy Selim et al.
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Case in brief
A nulliparous woman in her late seventies presented with progressive dyspnea, abdominal pain, and urinary frequency. Imaging showed large bilateral solid adnexal masses, initially without ascites; CA-125 was 14 U/mL, and MRI features and a Risk of Malignancy Index of 126 suggested low malignant potential. Surgery identified bilateral ovarian tumors and 300 mL of clear ascitic fluid. Histology showed bilateral fibromas, and ascitic-fluid cytology was negative for malignancy. Ascites and pleural effusions resolved completely after surgery, confirming bilateral Meigs’ syndrome; she remained asymptomatic without recurrence at follow-up.
What made this case unusual
The bilateral fibromas were associated with pleural effusions and ascites that was not detected on initial imaging, making the presentation an atypical bilateral form of Meigs’ syndrome.
Diagnostic / clinical pearl
In a patient with ovarian masses and pleural effusions, benign-appearing imaging, normal CA-125, and negative fluid cytology can support Meigs’ syndrome; resolution of the effusions after tumor removal confirmed the diagnosis in this case.