Meigs' syndrome with elevated serum cancer antigen 125 levels in a case of ovarian sclerosing stromal tumor

Jia-Hung Liou, Tzu Cheng Su, Jui-Chang Hsu
2011 Taiwanese Journal of Obstetrics & Gynecology  
Objective: Meigs' syndrome presenting as an ovarian tumor with elevated serum cancer antigen 125 (CA 125) levels is unusual. Only 37 cases have been reported, including three cases of ovarian sclerosing stromal tumor (SCT). Many reports have suggested that the presence of ascites is the major factor inducing mesothelial expression of CA 125. Case Report: An 18-year-old woman presented with massive ascites, elevated serum CA 125 levels, and radiographic evidence of ovarian tumor. The
more » ... or. The histological and immunohistochemical examinations revealed a benign SCT. Conclusion: SCT is a benign ovarian tumor and complete excision is curative. We also review all 37 cases and discuss possible mechanisms of Meigs' syndrome and elevated serum CA 125 level. An 18-year-old woman presented to the gastroenterology and hepatology outpatient department with a 6-month history of abdominal fullness, poor appetite, body weight loss, and irregular menses. Physical examination revealed abdominal distension, shifting dullness, and herniation of the umbilicus. There was no clinical or laboratory evidence of active excess hormone secretion. Ultrasonography revealed a 16.5-cm pelvic mass and massive ascites (Fig. 1) . Computed tomography revealed right pleural effusion with atelectasis in the right lower lung ( Fig. 2A) , a rounded mass in the pelvic region measuring 15 cm  14 cm  10 cm in size, and massive ascites (Fig. 2B) . There was no evidence of lymphadenopathy or metastatic lesions. Laboratory tests revealed high serum cancer antigen 125 (CA 125) levels (4,208.3 IU/mL); other tumor markers
doi:10.1016/j.tjog.2011.01.011 pmid:21791307 fatcat:inflfxpjojgphikbsmopzlybde