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Case report
Meigs syndrome presenting with severely elevated CA-125 level
  1. Alicia Palmieri1,
  2. Karim ElSahwi2 and
  3. Verda Hicks2
  1. 1Obstetrics & Gynecology, Jersey Shore University Medical Center, Neptune City, New Jersey, USA
  2. 2Gynecology Oncology, Jersey Shore University Medical Center, Neptune City, New Jersey, USA
  1. Correspondence to Dr Alicia Palmieri; alicia.palmieri{at}hmhn.org

Abstract

A 64-year-old woman referred to Gynaecological Oncology secondary to the finding of pelvic mass and ascites. Imaging showed multiple pelvic masses, with the largest mass measuring 20 cm in diameter, as well as bilateral pleural effusions and abdominal ascites, suspicious for ovarian carcinoma. Laboratory findings included elevated cancer antigen 125 (CA-125) of 2124 units/mL. The patient underwent an exploratory laparotomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy for pathological evaluation. Postoperatively, the patient had resolution of ascites and pleural effusion. Surgical pathology revealed a 26 cm right ovarian fibroma, confirming the diagnosis of Meigs syndrome. Despite the high suspicion for ovarian carcinoma in patients presenting with elevated CA-125 level, pelvic mass, ascites and pleural effusion, the diagnosis of Meigs syndrome cannot be excluded without pathological evaluation of mass.

  • obstetrics and gynaecology
  • gynaecological cancer

https://doi.org/10.1136/bcr-2020-238931

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    Footnotes

    • Twitter @tweetkarim

    • Contributors Dr KE, Dr VH and Dr AP all provided integral contributions to make this case report possible. Dr KE was the primary surgeon who cared for this patient. The idea for this article was formulated equally by all three authors. The literature search was carried out by Dr AP and Dr VH. The article was drafted by Dr AP, with editorial support provided by Dr VH and Dr KE. We also want to give thanks to our patient for allowing us to write up this case and share with others.

    • 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 for publication Obtained.

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