title: Pseudo-Meigs' syndrome caused by uterine smooth muscle tumor of uncertain malignant potential with low vascular endothelial growth factor expression.
abstract: Smooth muscle tumor of uncertain malignant potential (STUMP) presenting as pseudo-Meigs' syndrome with low vascular endothelial growth factor (VEGF) expression has not been reported in previous literature. Here, we report a case of uterine STUMP associated with ascites and pleural effusion, which was resolved completely after hysterectomy. A 47-year-old woman presented to the clinic with a complaint of progressive abdominal distension for several months. A large movable, painless pelvic mass located upward above the umbilical level was palpated. Sonography and computed tomography showed a hypervascular solid pelvic mass measuring 20 x 17 x 15 cm in size associated with ascites and right pleural effusion. Laparotomy revealed a large uterine mass with ascites in the abdomen. Total hysterectomy and left-side salpingo-oophorectomy were performed. The final pathologic report revealed a STUMP tumor with low expression of VEGF by immunohistochemistry. A follow-up chest X-ray revealed that the pleural effusion was resolved completely 1 week postoperatively. The patient is doing well without recurrence in the following 2 years. Uterine STUMP tumor may cause pseudo-Meigs' syndrome. However, the ascites or the pleural effusion may not be induced by VEGF, known as vascular permeability factor, in our case.
authors.affiliation: Department of Obstetrics and Gynecology, Chi Mei Medical Center, Liou Ying Campus, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: S E
authors.initials: SE
authors.lastname: Huang
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
authors.forename: W Y
authors.initials: WY
authors.lastname: Lee
authors.forename: K-F
authors.initials: KF
authors.lastname: Hsu
mesh_terms: D018450:Disease Progression; D015536:Down-Regulation; D005260:Female; D006801:Humans; D008539:Meigs Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000000981:diagnostic imaging; D011859:Radiography; D018235:Smooth Muscle Tumor / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D014594:Uterine Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A