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Meigs syndrome and elevated CA 125.

O W Jones1, E A Surwit

  • 1Department of Obstetrics and Gynecology, University Medical Center, Tucson, Arizona.

Obstetrics and Gynecology
|March 1, 1989
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Summary
This summary is machine-generated.

Meigs syndrome, a rare condition, can cause elevated cancer antigen 125 (CA 125) levels. This case highlights that high CA 125 does not always signify ovarian cancer, even with ascites and pleural effusion.

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Area of Science:

  • Gynecologic Oncology
  • Oncology
  • Internal Medicine

Background:

  • Meigs syndrome is characterized by a triad of ovarian fibroma-thecoma, ascites, and pleural effusion.
  • Elevated serum cancer antigen 125 (CA 125) levels are often associated with ovarian malignancy.
  • Distinguishing benign conditions from malignancy can be challenging in gynecologic oncology.

Observation:

  • A patient presented with symptoms suggestive of malignancy, including a pelvic mass, ascites, and significantly elevated CA 125 (226 U/mL).
  • Surgical exploration revealed a benign fibroma-thecoma, with no malignant cells detected in the ascitic fluid.
  • Post-surgical resolution of the pleural effusion and a decrease in CA 125 to 32 U/mL were observed.

Findings:

  • This case represents the first documented instance of Meigs syndrome co-occurring with an elevated CA 125 level.
  • The findings support existing literature suggesting that elevated CA 125 is not exclusively indicative of malignancy.
  • Benign ovarian tumors can, in rare cases, lead to elevated CA 125 levels and symptoms mimicking advanced cancer.

Implications:

  • The case underscores the importance of a comprehensive diagnostic approach in patients with pelvic masses and elevated CA 125.
  • It emphasizes that elevated CA 125 levels should be interpreted within the full clinical context, including imaging and surgical findings.
  • This report may help reduce unnecessary aggressive treatment for presumed ovarian cancer in similar benign conditions.