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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
  1. Mehrnoosh Pauls1,
  2. Heather MacKenzie1 and
  3. Ravi Ramjeesingh2
  1. 1 Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2 Medicine, QE2 Health Science Center, Halifax, Nova Scotia, Canada
  1. Correspondence to Dr Mehrnoosh Pauls, maghaei{at}


The clinical scenario of a female patient with a pelvic mass, elevated CA125 tumour marker, pleural effusion and ascites is often associated with malignancy. However, not all cases are malignant. Non-malignant diseases, such as Meigs syndrome and pseudo-Meigs syndrome, must be part of your differential. We present a 56-year-old woman with dyspnoea secondary to a right pleural effusion. After further investigations, a serum cancer antigen-125 was found to be elevated at 437.3 U/mL. CT of her abdomen and pelvis showed a large heterogeneous mass in the pelvis measuring 13.2×9.7×15.1 cm with mild ascites. She was initially thought to have ovarian carcinoma and underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy with omental biopsy. Pathology from the surgical specimen revealed a hydropic leiomyoma and after removal of pelvic mass her pleural effusion and ascites completely resolved. She was ultimately diagnosed with the rare pseudo-Meigs syndrome.

  • medical education
  • obstetrics and gynaecology
  • oncology

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  • Contributors MP made significant contributions to project and manuscript development, data collection, data analysis, result dissemination and knowledge translation. HM made significant contributions to project and writing the case section of manuscript. RR made significant contributions to project and manuscript, and knowledge translation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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