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Meigs' syndrome with elevated CA 125: case report.

Sabas Carlos Vieira1, Leonardo Halley Carvalho Pimentel, José Carlos Castelo Branco Ribeiro

  • 1Hospital São Marcos, Teresina, Piauí, Brazil.

Sao Paulo Medical Journal = Revista Paulista De Medicina
|December 11, 2003
PubMed
Summary

Meigs' syndrome, a benign ovarian tumor with ascites and hydrothorax, can present with elevated CA 125 levels. This case highlights that high CA 125 does not always indicate ovarian cancer, even with solid adnexal masses.

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Area of Science:

  • Gynecologic Oncology
  • Reproductive Medicine
  • Surgical Pathology

Background:

  • Meigs' syndrome is characterized by a benign ovarian tumor, ascites, and pleural effusion.
  • Elevated serum CA 125 levels in postmenopausal women typically suggest ovarian malignancy.
  • This case explores the diagnostic challenge of elevated CA 125 in Meigs' syndrome.

Observation:

  • A 65-year-old woman presented with dyspnea, ascites, and a pelvic mass.
  • Imaging revealed a large left ovarian solid mass, and serum CA 125 was elevated.
  • Initial diagnosis considered ovarian carcinoma, prompting surgical intervention.

Findings:

  • Exploratory laparotomy identified a left ovarian tumor.
  • Frozen section and subsequent histology confirmed thecoma, a benign ovarian tumor.

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  • The patient underwent total hysterectomy with bilateral salpingo-oophorectomy.

    • Implications:

    • This case underscores that elevated CA 125 can occur in benign conditions like Meigs' syndrome.
    • It emphasizes the importance of comprehensive evaluation to differentiate benign from malignant ovarian masses.
    • Accurate diagnosis and timely surgical management led to a favorable outcome, with the patient remaining asymptomatic.