title: Demons-meigs pseudosyndrome mimicking the symptoms of pregnancy: a case report.
abstract: BACKGROUND
  The Demons-Meigs syndrome should usually be evoked in case of presence of a typical triad: abdominopelvic mass, ascites and hydrothorax. Its diagnosis appears crucial to prevent the realization of unnecessary surgical procedures.
  
  
  METHODS
  A 32-year-old woman presented in April 2012 to the emergency department of our maternity unit (General Hospital, Thiers, France) with an abdominal distension mimicking the symptoms of a pregnancy at term. Physical examination revealed a voluminous painful abdominopelvic mass, extended from the pelvis to the upper abdomen with a large right pleural effusion. Ultrasound and computed tomography showed it was a tumor measuring more than 300 mm in diameter with a right hydrothorax. Serum CA-125 level was 289 U/ml. Cytologic analysis of the pleural effusion didn't show any malignant cells. In this study, Demons-Meigs syndrome was recognized. A laparoscopico-laparotomic management permitted an aspiration of 23 liters of a brownish liquid and an unilateral adnexectomy after pleural paracentesis was performed. Frozen section demonstrated benign mucinous cystadenoma. The final histologic findings objectified intracystic intestinal type ovarian mucinous borderline tumor. After multidisciplinary consultation, the patient was re-operated one month later. The exploration didn't reveal any suspected lesions and appendectomy and omentectomy were performed. The postoperative course was uneventful. Serum CA-125 level was normal at the time of the reoperation and 24 months after the initial surgery.
  
  
  CONCLUSIONS
  The preoperative recognition of a Demons-Meigs syndrome or a Demons' pseudosyndrome is essential to avoid useless surgical procedures.
authors.affiliation: Department of Obstetrics and Gynecology, General Hospital of Thiers, Thiers, France ; Department of Surgery, General Hospital of Thiers, Thiers, France.
authors.forename: Erdogan
authors.initials: E
authors.lastname: Nohuz
authors.affiliation: Department of Obstetrics and Gynecology, General Hospital of Thiers, Thiers, France.
authors.forename: Maher
authors.initials: M
authors.lastname: Alaboud
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, General Hospital of Thiers,Thiers, France.
authors.forename: Bilal
authors.initials: B
authors.lastname: El-Drayi
authors.affiliation: Department of Obstetrics and Gynecology, General Hospital of Grosseto, Grosseto, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tamburro
authors.affiliation: Department of Radiology, General Hospital of Thiers, Thiers, France.
authors.forename: Said
authors.initials: S
authors.lastname: Kachkach
authors.affiliation: Department of Surgery, General Hospital of Thiers, Thiers, France.
authors.forename: Janos
authors.initials: J
authors.lastname: Varga
keywords: Abdominal mass; Demons-Meigs syndrome; Hydrothorax; Meigs; Ovarian benign tumor