medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...

, Meigs's syndrome, also Meigs syndrome or Demons–Meigs syndrome, is the triad of

ascites Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, ab ...

pleural effusion A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilog ...

, and benign

ovarian tumor Ovarian tumors, or ovarian neoplasms, are tumors arising from the ovary. They can be benign or malignant (ovarian cancer). They consist of mainly solid tissue, while ovarian cysts contain fluid. Histopathologic classification Ovarian tumors are ...

(

ovarian fibroma The ovarian fibroma, also fibroma, is a benign sex cord-stromal tumour. Ovarian fibromas represent 4% of all ovarian neoplasms. They tend to occur mostly during perimenopause and postmenopause, the median age having been reported to be about 52 y ...

, fibrothecoma,

Brenner tumour Brenner tumors are an uncommon subtype of the surface epithelial-stromal tumor group of ovarian neoplasms. The majority are benign, but some can be malignant. They are most frequently found incidentally on pelvic examination or at laparotomy. B ...

, and occasionally

granulosa cell tumour Granulosa cell tumours are tumours that arise from granulosa cells. They are estrogen secreting tumours and present as large, complex, ovarian masses. These tumours are part of the sex cord-gonadal stromal tumour or non-epithelial group of tumours ...

). Meigs syndrome resolves after the resection of the

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The causes of the ascites and pleural effusion are poorly understood. Atypical Meigs syndrome, characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur. As in typical Meigs syndrome, pleural effusion resolves after removal of the pelvic mass.

Diagnosis

Differential diagnosis

Meigs syndrome may mimic other conditions, since it is tumor arising from ovaries, pathology of any organs present in the abdomen may show a similar set of symptoms. These include various gynecological disorders of the uterus such as endometrial tumor, sarcoma, leiomyoma (pseudo-Meigs syndrome); fallopian tube disorders such as hydrosalpinx, granulomatous salpingitis, fallopian tube malignancy; ovarian disorders such as serous, mucinous, endometrioid, or clear cell carcinoma, Brenner tumor, granulosa cell tumor, stromal tumor, dysgerminoma, fibroma, or metastatic tumor to the ovary. Meigs syndrome is characterized by the presence of a benign solid ovarian tumor associated with ascites and right hydrothorax that disappear after tumor removal. Non-gynecological manifestations include: ascites, portal vein obstruction, inferior vena cava obstruction, hypoproteinaemia, thoracic duct obstruction, tuberculosis, amyloidosis, pancreatitis, ovarian hyperstimulation,

exudate An exudate is a fluid emitted by an organism through pores or a wound, a process known as exuding or exudation. ''Exudate'' is derived from ''exude'' 'to ooze' from Latin ''exsūdāre'' 'to (ooze out) sweat' (''ex-'' 'out' and ''sūdāre'' 'to ...

pleural effusion, congestive heart failure, metastatic tumors to the peritoneal surfaces, collagen-vascular disease, and cirrhosis of the liver. These entities must be clinically excluded. Clinical condition characterized by ovarian mass, ascites, and right-sided pleural effusion. Ovarian malignancy and the other causes of pelvic mass, ascites, and pleural effusion to be considered, History of early satiety, weight loss with increased abdominal girth, bloating, intermittent abdominal pain, dyspnea, nonproductive cough may help in differentiating potential local factor causing such symptoms.

Treatment

Treatment of Meigs syndrome consists of

thoracentesis Thoracentesis , also known as thoracocentesis (from Greek ''thōrax'' 'chest, thorax'—GEN ''thōrakos''—and ''kentēsis'' 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive med ...

and

paracentesis Paracentesis (from Greek κεντάω, "to pierce") is a form of body fluid sampling procedure, generally referring to peritoneocentesis (also called laparocentesis or abdominal paracentesis) in which the peritoneal cavity is punctured by a needl ...

to drain off the excess fluid (exudate), and unilateral

salpingo-oophorectomy In medicine, salpingo-oophorectomy is the removal of an ovary and its Fallopian tube. This procedure is most frequently associated with prophylactic surgery in response to the discovery of a BRCA mutation, particularly those of the normally tumor ...

or wedge resection to correct the underlying cause.

Eponym

Meigs syndrome is named for

Joe Vincent Meigs Joe Vincent Meigs (October 24, 1892, Lowell, Massachusetts – October 24, 1963), was an American obstetrician and gynecologist. Meigs was a grandson of Captain Joe Vincent Meigs, who invented an experimental steam monorail known as the Meigs Eleva ...

References

External links

{{Breast cancer/urogenital neoplasia Gynaecologic disorders Oncology Syndromes with tumors Medical triads