title: [Ascites, pleural effusion and a benign ovarian tumour; the triad of Meigs' syndrome].
abstract: Classical Meigs' syndrome consists of the triad of an ovarian fibroma, ascites and pleural effusion. A characteristic of the syndrome is that the excess fluid is resorbed after surgical resection of the tumour.
  
  
  
  A 49-year-old woman was admitted to accident and emergency department in a neglected, cachectic and hypothermic condition. A CT scan revealed an ovarian tumour, ascites and a right-sided pleural effusion. The level of the tumour marker CA-125 was also greatly elevated. Our initial working diagnosis was, therefore, 'high-grade ovarian carcinoma', but on repeated testing no malignant cells were found in the aspirated fluid. We suspected Meigs' syndrome. We first ensured that her general and nutritional condition improved; then she underwent a bilateral adnexectomy. A fibrothecoma was found in each ovary. The ascites and pleural effusion resolved following surgery and the patient recovered well.
  
  
  
  The clinical picture of Meigs' syndrome can resemble that of high-grade ovarian carcinoma. This syndrome should be included in the differential diagnosis in patients with an ovarian tumour, ascites and, possibly, pleural effusion.
authors.affiliation: Westfriesgasthuis, Hoorn.
authors.forename: B J
authors.initials: BJ
authors.lastname: Laan
authors.forename: S M
authors.initials: SM
authors.lastname: van den Heiligenberg
authors.forename: M
authors.initials: M
authors.lastname: Hemelaar
mesh_terms: D001201:Ascites / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008539:Meigs Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010996:Pleural Effusion / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D018394:CA-125 Antigen