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[Meigs syndrome with bilateral hydrothorax]
O Santopaolo1, A Rotondo, M Alfè
1Cattedra di Chirurgia Toracica, II Facoltà di Medicina, Università degli Studi di Napoli Federico II, Napoli.
Minerva Ginecologica
|May 1, 1993
Summary
Meigs syndrome involves pelvic tumors, ascites, and hydrothorax. Surgical removal of the pelvic neoplasm resolves these effusions, confirming the tumor
Area of Science:
- Gynecologic Oncology
- Pulmonology
- Pathophysiology
Background:
- Meigs syndrome, first described in 1937, is characterized by the co-existence of a pelvic tumor, hydrothorax, and ascites.
- Initially, Meigs syndrome was exclusively associated with ovarian neoplasms, but current understanding includes uterine tumors like fibromas.
- Distinguishing typical Meigs syndrome from pseudo-Meigs syndrome relies on the presence of an ovarian or uterine neoplasm.
Observation:
- The syndrome presents with moderate to massive pleural and peritoneal effusions, typically transudative but occasionally containing blood.
- Pelvic tumors associated with Meigs syndrome, particularly ovarian tumors, often exceed 6 cm in diameter.
- Effusions regress upon surgical excision of the pelvic neoplasm, establishing a direct etiological link.
Findings:
- The pathogenesis suggests peritoneal fluid filtration through the tumor capsule and subsequent pleural diffusion via diaphragmatic lymphatics.
- Ovarian tumors, when implicated, originate from connective tissue, appear during reproductive years, and exhibit slow growth.
- Clinical manifestations often become apparent in older age groups.
Implications:
- Understanding Meigs syndrome is crucial for accurate diagnosis and management of patients presenting with unexplained ascites and hydrothorax.
- The syndrome highlights the complex interplay between gynecologic neoplasms and systemic fluid dynamics.
- Further research into the specific mechanisms of fluid transport could refine diagnostic and therapeutic strategies.