Meigs Syndrome and Related Ovarian Tumor Phenomena

Meigs syndrome is classically defined by the triad of a benign ovarian stromal tumour, ascites and hydrothorax that resolve upon surgical removal of the tumour. Although most commonly associated with fibromas, the spectrum of related phenomena now includes pseudo-Meigs syndromes in which malignant or non-fibroma lesions produce a similar clinical picture. Elevated levels of cancer antigen-125 (CA-125) frequently complicate the diagnostic pathway and may lead to misclassification as ovarian carcinoma. Pathophysiological mechanisms are thought to involve peritoneal irritation, lymphatic obstruction and altered capillary permeability. Clinically, distinguishing benign from malignant aetiologies is crucial to avoid overtreatment, yet standard imaging and serum markers alone often lack specificity. Current research aims to refine non-invasive diagnostic modalities, elucidate the molecular drivers of serous fluid accumulation, and clarify the relationship between tumour histotype and biochemical profile. Improved recognition of variant presentations—including pseudo-pseudo Meigs’ associated with systemic conditions—underscores the need for multidisciplinary assessment to guide management and optimise patient outcomes.

Research from Nature Portfolio

A retrospective study of 18F-FDG PET/CT in patients with Meigs syndrome induced by ovarian sex-cord stromal tumours compared metabolic parameters with those of patients exhibiting pseudo-Meigs caused by malignant ovarian carcinoma. The investigation demonstrated significantly lower maximum and mean standardized uptake values in benign stromal tumours, despite similar lesion size and density. Interestingly, the volume of serous effusions correlated positively with CA-125 levels but was unrelated to tumour metabolic activity. These findings suggest that quantitative PET/CT metrics, combined with serum marker analysis, can improve pre-operative differentiation between benign and malignant processes, potentially reducing unnecessary radical surgery.

Meigs Syndrome and Related Ovarian Tumor Phenomena publication trend

The graph below shows the total number of articles in meigs syndrome and related ovarian tumor phenomena across all publications each year (not limited to Nature Index journals).

Technical terms

Meigs syndrome: Triad of a benign ovarian tumour with ascites and pleural effusion that resolves after tumour removal.

Pseudo-Meigs syndrome: Similar clinical presentation caused by malignant ovarian neoplasms or other pelvic tumours.

CA-125: Cancer antigen-125, a glycoprotein biomarker elevated in ovarian malignancies and certain benign conditions.

18F-FDG PET/CT: Combined positron emission tomography and computed tomography using fluorodeoxyglucose to assess tumour metabolism.

SUVmax: Maximum standardized uptake value, indicating peak tracer concentration within a lesion on PET imaging.

Sex-cord stromal tumour: Ovarian neoplasm derived from stromal cells, often benign and implicated in Meigs syndrome.

References

1. Case report: Three cases of systemic lupus erythematosus presenting primarily with massive ascites and significantly elevated CA-125 levels and a review of pseudo-pseudo Meigs’ syndrome in literature. Frontiers in Immunology (2024).
2. 18F-FDG PET/CT features of Meigs syndrome induced by ovarian sex cord stromal tumors: a retrospective clinical study. Scientific Reports (2024).
3. Meigs Syndrome and Elevated CA-125: Case Report and Literature Review of an Unusual Presentation Mimicking Ovarian Cancer. Medicina (2023).