Meigs syndrome presenting with severely elevated CA-125 level

2021 ◽  
Vol 14 (3) ◽  
pp. e238931
Author(s):  
Alicia Palmieri ◽  
Karim ElSahwi ◽  
Verda Hicks
Keyword(s):  
Pleural Effusion ◽  
Ovarian Carcinoma ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Laboratory Findings ◽  
Pathological Evaluation

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.

scholarly journals Hydropic leiomyoma presenting as a rare condition of pseudo-Meigs syndrome: literature review and a case of a pseudo-Meigs syndrome mimicking ovarian carcinoma with elevated CA125

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-226454 ◽  
Author(s):  
Mehrnoosh Pauls ◽  
Heather MacKenzie ◽  
Ravi Ramjeesingh
Keyword(s):  
Pleural Effusion ◽  
Ovarian Carcinoma ◽  
Pelvic Mass ◽  
Rare Condition ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Tumour Marker ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Surgical Specimen

The clinical scenario of a female patient with a pelvic mass, elevated CA125 tumour marker, pleural effusion and ascites is often associated with malignancy. However, not all cases are malignant. Non-malignant diseases, such as Meigs syndrome and pseudo-Meigs syndrome, must be part of your differential. We present a 56-year-old woman with dyspnoea secondary to a right pleural effusion. After further investigations, a serum cancer antigen-125 was found to be elevated at 437.3 U/mL. CT of her abdomen and pelvis showed a large heterogeneous mass in the pelvis measuring 13.2×9.7×15.1 cm with mild ascites. She was initially thought to have ovarian carcinoma and underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy with omental biopsy. Pathology from the surgical specimen revealed a hydropic leiomyoma and after removal of pelvic mass her pleural effusion and ascites completely resolved. She was ultimately diagnosed with the rare pseudo-Meigs syndrome.

scholarly journals Multicystic Benign Cystic Mesothelioma Presenting as a Pelvic Mass

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mazdak Momeni ◽  
Elena Pereira ◽  
Gennadiy Grigoryan ◽  
Konstantin Zakashansky
Keyword(s):  
Preoperative Evaluation ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Lymphangioma ◽  
Ca 125 ◽  
Pathologic Evaluation ◽  
Pelvic Peritoneum ◽  
Cystic Mesothelioma

Background.Benign cystic mesothelioma (BCM) is a rare tumor that arises from the abdominal peritoneum with a predilection to the pelvic peritoneum. For this reason, it can often mimic gynecologic malignancies.Case.A 47-year-old perimenopausal female presented reporting several weeks of abdominal distention associated with abdominal tenderness and constipation. Computed tomography revealed a 24 cm multiloculated pelvic mass, and tumor markers were notable for an elevated CA-125. The patient was taken to the operating room for an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingoophorectomy, and removal of pelvic mass. Final pathologic evaluation revealed a benign cystic mesothelioma.Conclusion.Classically these tumors present as large multicystic masses with thin-walled septations and on preoperative evaluation BCM can mimic many different disease entities including ovarian malignancies and cystic lymphangioma. Often diagnosis can only be made at time of surgery.

scholarly journals Borderline Clear Cell Adenofibroma of the Ovary

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Pilaiwan Kleebkaow ◽  
Apiwat Aue-aungkul ◽  
Amornrat Temtanakitpaisan ◽  
Chumnan Kietpeerakool
Keyword(s):  
Clear Cell ◽  
Pelvic Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ca 125 ◽  
Stromal Invasion ◽  
Post Operation ◽  
Clear Cytoplasm ◽  
Gross Examination ◽  
Clear Cell Adenofibroma

Borderline clear cell tumors are extremely rare, and few cases have been reported in the literature. Herein, we present a case of borderline clear cell adenofibroma of the ovary in a 58-year-old woman who presented with a pelvic mass and constipation. Physical examination revealed a 10 cm solid midline pelvic mass. Computed tomography showed an 8 cm heterogeneous enhancing mass attached to the left posterolateral wall of the uterus. The patient’s serum CA 125 levels were slightly elevated (80.9 U/ml). The patient was given a total abdominal hysterectomy with bilateral salpingooophorectomy. On gross examination, it was found that the left ovarian tumor was an 8.0 × 7.5 × 8.0 cm solid multilobulated mass containing tiny cysts. Histologically, the tumor was composed of small glands in dense fibrous and myxoid stroma. The glands were lined with cuboidal cells with clear cytoplasm and mild to moderate nuclear atypia. No stromal invasion was observed. The pathological diagnosis was borderline clear cell adenofibroma of the left ovary. There was no reoccurrence 36 months post operation.

scholarly journals A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma

2014 ◽  
Vol 2 (1) ◽  
pp. 44-45 ◽  
Author(s):  
Ishita Mishra ◽  
Nimish C Pandya ◽  
Nilopher Surti ◽  
Babu S Patel
Keyword(s):  
Developing Countries ◽  
Ovarian Carcinoma ◽  
Exploratory Laparotomy ◽  
Reproductive Age ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Peritoneal Tuberculosis ◽  
Cancer Antigen 125 ◽  
Diagnostic Modality ◽  
Major Health Problem

ABSTRACT Background Mycobacterium tuberculosis affects about 30% of world's population and infection occurs at a rate of one per second. In 2010, tuberculosis accounted for 8.8 million new cases, was responsible for 1.45 million deaths with majority of cases in developing countries. Tuberculosis is the most common cause of mortality in women of reproductive age. Peritoneal tuberculosis accounts for 4% of all extrapulmonary diseases and often mimics ovarian malignancy due to its nonspecific symptoms. Case A 25-year-old woman with ovarian mass and an elevated cancer antigen 125 (CA-125) underwent an exploratory laparotomy to search for ovarian tumor. The final pathological diagnosis was miliary abdominal tuberculosis. Discussion Peritoneal tuberculosis often mimics ovarian malignancy due to its nonspecific symptoms and is a major health problem in developing countries. There is no particular diagnostic test to differentiate this disease from advanced ovarian carcinoma, making it difficult to avoid extensive surgery. Laparoscopy is the diagnostic modality of choice. How to cite this article Surti N, Patel BS, Pandya NC, Mishra I. A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma. J South Asian Feder Menopause Soc 2014;2(1):44-45.

scholarly journals High grade endometrial stromal sarcoma: a clinician dilemma

2021 ◽  
Vol 9 (8) ◽  
pp. 2493
Author(s):  
Poojan Dogra ◽  
Shuchi Sharma ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Tumor Cells ◽  
Pelvic Mass ◽  
Endometrial Stromal Sarcoma ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Anterior Wall ◽  
Pelvic Lymphadenectomy ◽  
Stromal Sarcoma ◽  
Endometrial Thickening

Uterine sarcomas are relatively rare tumors of mesodermal origin. ESS occurs primarily in perimenopausal women in 4th and 5th decade of their life; about one third occurs in postmenopausal women. Here in we describe a case of 44 years old patient presented with one month history of foul smelling discharge per vagina and a pelvic mass. Ultrasound and MRI gave possibility of a large anterior wall and fundal fibroid with degeneration versus neoplastic endometrial thickening. The patient underwent exploratory laparotomy with total abdominal hysterectomy with bilateral salpingoophorectomy with pelvic lymphadenectomy. Histopathology showed tumor cells with round to oval nuclei with high mitotic activity, blood vessel proliferation between the tumor cells and extensive lymphovascular invasion. The pathological diagnosis was HG-ESS stage IB. The patient was referred to radiotherapy department for adjuvant therapy. HG-ESS is a rare clinical entity and considered as important differential diagnosis.

scholarly journals Hereditary mucinous ovarian cancer complicated with omental metastasis: A case report

2021 ◽  
Vol 29 (1) ◽  
pp. 83-88
Author(s):  
Adhir Kumar Das
Keyword(s):  
Ovarian Cancer ◽  
Malignant Tumors ◽  
Pelvic Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Mucinous Cystadenocarcinoma ◽  
Cancer Antigen 125 ◽  
Brca Mutations ◽  
Kras Mutations ◽  
First Case

Approximately 80% ovarian tumorsare benign, and these arise mostly in young adult females. Malignant tumors are more prevalent in ageing women, between the ages of 45-65 years. Mucinous ovarian cancer represents about 5% of epithelial ovarian cancers (EOC).We have reported a case of mucinous cystadenocarcinoma in 35-year-old lady with metastasis to omentum.Imaging (radiograph & CT scan) studies showed a large right sided pelvic mass with probable origin in the right ovary. Cancer antigen-125 was elevated, while carcinoembrionic antigen and alphafetoprotein were normal. Mutational profiles shown distinct finding, as KRAS mutations positive nevertheless p53 and BRCA mutations are absent. She had undergone total abdominal hysterectomy with bilateral salphingo-oopherectomy along with pelvic dissection for removal of lymph nodes at the age of 35. She was given advice for radiotherapy with 3 cycles of chemotherapy with cisplatin and paclitaxel. To the best of our knowledge, this is the one of the littlecase of ovarian mucinous cystadenocarcinoma being reported at a relatively young age, and the first case being reported from Bangladesh. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 83-88

Peritoneal Tuberculosis: A Retrospective Review of 20 Cases and Comparison With Primary Peritoneal Carcinoma

2010 ◽  
Vol 20 (5) ◽  
pp. 798-803 ◽  
Author(s):  
Chel Hun Choi ◽  
Chul-Jung Kim ◽  
Yoo-Young Lee ◽  
Joo Sun Kim ◽  
Taejong Song ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Medical Center ◽  
Control Sample ◽  
Exploratory Laparotomy ◽  
Tissue Reaction ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
Cancer Antigen 125 ◽  
Peritoneal Carcinoma ◽  
Primary Peritoneal Carcinoma

Introduction:To evaluate the clinical features of peritoneal tuberculosis (TB) and to compare them with those of primary peritoneal carcinoma (PPC).Methods:We conducted a retrospective review of women with peritoneal TB who were managed at Samsung Medical Center from January 1996 to October 2006. As a control sample, patients with a diagnosis of PPC during the same period were also selected for comparison.Results:During the study period, we identified 20 female patients with peritoneal TB. The median age was 39 years (range, 23-69 years), and the median cancer antigen 125 (CA-125) level was 448 U/mL (range, 32-1725 U/mL). Seventeen patients with PPC whom we examined were older, with a median age of 63 years (range, 50-73 years); their median CA-125 level was higher at 1848 U/mL (range, 42-14,380 U/mL). Compared with those of PPC, the radiologic findings of peritoneal TB indicated less severe involvement of the omentum and the mesentery (P = 0.03). Among the 20 patients who underwent operations, 6 (30%) underwent exploratory laparotomy; 12 (60%), diagnostic laparoscopy; and 2 (10%), laparoscopy converted to laparotomy because of severe adhesion. Frozen tissue sections revealed chronic granulomatous tissue reaction in 15 (83.3%) of 18 women with peritoneal TB.Conclusions:Maintaining a high index of suspicion is very important for the successful treatment of peritoneal TB, especially in developing countries. Age, CA-125 level, and omental involvement as identified by computed tomography may be helpful for the differential diagnosis of peritoneal TB and PPC.

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

scholarly journals MUCINOUS CYSTADENOCARCINOMA

2018 ◽  
Vol 16 (2) ◽  
pp. 59
Author(s):  
Sadia Anwar ◽  
Nasim Saba
Keyword(s):  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Genetic Mutation ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ca 125 ◽  
Invasive Adenocarcinoma ◽  
Epithelial Tumor ◽  
Glandular Cells

A 55 years old lady presented to Gynecology outpatient of MMM Teaching Hospital, D.I.Khan in January 2018 with history of abdominal mass. Her abdominal hysterectomy was done one year back. On examination a huge cystic mass reaching up to the xiphisternum and occupying the whole abdomen was palpable. Her ultrasound revealed a mass arising from pelvis, most likely ovarian in nature. Her CA-125 level was 29.62 IU/ml (in normal range). Exploratory laparotomy revealed a huge cystic mass which was excised. Histopathology reported mucinous cystadenocarcinoma of the ovary. Chemotherapy was then done. There was no recurrence by the end of nine months follow-up as evaluated by ultrasonography. Mucinous cystadenocarcinoma is an invasive adenocarcinoma composed of malignant glandular cells containing intracytoplasmic mucin. It is relatively common in middle-aged women. Genetic mutation such as KRAS gene have been reported. It is a rapidly growing epithelial tumor usually presenting as a single solid mass. Treatment involves surgery and chemotherapy. The prognosis depends upon the stage of tumor.

scholarly journals The Imaging and Pathological Features of Metastatic Leiomyosarcoma in the Gallbladder

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Yi Guo ◽  
Eleanor Chen ◽  
Darin J. Davidson ◽  
Venu G. Pillarisetty ◽  
Robin L. Jones ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Metastatic Lesion ◽  
Uterine Leiomyosarcoma ◽  
High Grade ◽  
Initial Management ◽  
Pelvic Radiation

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.

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