Definition

What is Meigs Syndrome?

Meigs syndrome is a triad of medical conditions where there is a benign ovarian tumor (specifically an ovarian fibroma) with ascites (fluid accumulation in the abdominal cavity) and pleural effusion (fluid around the lungs in the pleural space).

How common is Meigs Syndrome?

Meigs Syndrome is rare. It tends to occur most often in postmenopausal women, particularly around the age of 50..Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Meigs Syndrome?

The common symptoms of Meigs Syndrome are:

  • Shortness of breath
  • Fatigue
  • Increased abdominal size
  • Weight loss
  • Amenorrhea for premenopausal women
  • Bloating
  • Dullness of percussion of lungs
  • Tachycardia
  • Present of ascites
  • Present of pelvic mass
  • Abdominal examination may feel the mass

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Meigs Syndrome?

Meigs syndrome occurs in the backdrop of benign ovarian tumors and specifically a fibroma. When the syndrome occurs with other types of benign ovarian tumors other than a fibroma, it is known as pseudo-Meigs syndrome. It may also include a pleural effusion and ascites with cancerous ovarian tumors and even conditions like systemic lupus erythematosus (SLE) with enlarged ovaries. Some of these conditions in pseudo-Meigs can have very severe and potentially life threatening outcomes.

Although there are several hypotheses about the pathophysiology (disease mechanism), the exact reason why ascites and pleural effusions occur with a benign ovarian tumor is unclear. It is also not known where the fluid originates from, whether from the tumor or ovary, or leaking from blood vessels or lymphatics. There are several studies to suggest that the fluid in the pleural effusion is common to a large extent with the the ascitic fluid. The characteristic feature of Meigs syndrome is resolution of the ascites and pleural effusion with removal of the tumor. Therefore the benign ovarian tumor plays a central role in the syndrome.

Risk factors

What increases my risk for Meigs Syndrome?

Old age can increase the risk of getting ovarian tumor. Women in the menopause stage are prone to get ascitis and tumor in the ovary. Obesity, diabetes and smoking can also trigger formation of tumor. Prolonged use of oral contraceptive pills and undergoing hormone therapy can increase the risk of this syndrome. Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Meigs Syndrome diagnosed?

Various diagnostic tests should be conducted for Meigs syndrome. One of the main reasons that these investigations should be undertaken is to exclude serious underlying causes other than the association with benign ovarian tumors. Ascites and pleural effusion can occur with a number of different conditions ranging from cancers to liver, heart and kidney failure. Investigations may include laboratory tests on blood and fluid samples as well as imaging studies. Some of these tests include :

  • Blood – complete blood count, urea and electrolytes and CA125 levels.
  • Abdominal and pelvic ultrasound, CT scan of the abdomen and pelvis and chest x-ray.
  • Fluid collection from the abdomen (paracentesis) and pleural space (thoracentesis) or a Pap smear.

How is Meigs Syndrome treated?

Your doctor will first have to look for the underlying causes for treating Meigs syndrome. For patients with cirrhosis salt intake will be restricted. Diuretic medications like spironolactone are prescribed. For women with refractory ascites taking therapeutic paracentesis will be beneficial and the procedure needs to be made in sterile environment.

Alternatively TIPS transjugular intrahepatic porotsystemic shunt is done for refractory ascites and the procedure of paracentesis is to be done for every 4 months. Doing paracentesis will give temporary relief from the symptoms and shunts are effective for managing malignant ascites. For mild forms of ovarian cyst no treatment is required but your doctor will have to monitor your pelvis regularly for any changes.

Surgery

Laparoscopy is a procedure in which small incision is made on the abdomen for removing the cyst surgically. It is effective for treating small sized cysts which are benign. Laparotomy is done for removing large sized cyst or ovarian tumors. For malignant type of tumors, chemotherapy is done in which drugs are given directly into the stomach for killing cancer cells. But this procedure will have side effects like nausea, vomiting, kidney disease and risk of getting infection.

Radiation therapy is effective in shrinking cancer cells in the ovary. Customized treatment and therapy is given based on the health condition and intensity of the tumor involved. Women in the post-menopause stage will undergo bilateral salpingo oopherectomy or total hysterectomy depending on the situation. For women in the reproductive stage unilateral salpingo oophorectomy is done.

 

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Meigs Syndrome?

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 22, 2018 | Last Modified: May 22, 2018

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