Palliative Surgery for Respiratory Failure Caused by Massive Pleural Effusion in a Patient Suffering From a Metastatic Ovarian Tumor From Colon Cancer ‒ Pseudo-Meigsʼ Syndrome : A Case Report and Literature Review

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  • RYUJIN Keiichiro
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center
  • KOREHISA Shotaro
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center
  • MINAMI Yu
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center
  • TAKIZAWA Katsumi
    Department of Pathology, National Hospital Organization Fukuokahigashi Medical Center
  • NOBUTO Yoshinari
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center
  • TSUJITA Eiji
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center
  • UCHIYAMA Hideaki
    Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center

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Other Title
  • 大腸癌からの転移性卵巣腫瘍に随伴する大量胸水による呼吸不全に 対する緩和手術-pseudo-Meigs症候群 : 症例報告および文献的考察
  • Palliative Surgery for Respiratory Failure Caused by Massive Pleural Effusion in a Patient Suffering From a Metastatic Ovarian Tumor From Colon Cancer : Pseudo-Meigs' Syndrome : A Case Report and Literature Review

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Abstract

Meigsʼ syndrome is characterized by benign ascites and hydrothorax associated with the fibrous neoplasm, generally fibromas of the ovaries. The ascites and hydrothorax resolve by resecting such ovarian tumors. The ovarian malignancy and metastatic tumors of the ovaries can also cause the same syndrome with benign hydrothorax and ascites. In such cases, the condition is called pseudo-Meigsʼ syndrome. Herein, we present a successful palliative surgery for pseudo-Meigsʼ syndrome due to a metastatic ovarian tumor from colon cancer. A 79-year-old woman was transferred to our hospital for the treatment of refractory hydrothorax. Computed tomography and colonoscopy revealed ascending colon cancer with lymph node metastases, a large right primary or metastatic ovarian tumor, and massive pleural effusion. The patientʼs general condition gradually worsened toward respiratory failure. Therefore, a rescue operation, including a right hemicolectomy with lymph node dissection, the resection of peritoneal dissemination, and the resection of the ovarian tumor, was performed. The amount of pleural effusion markedly decreased after the operation, and the patient was diagnosed with pseudo-Meigsʼ syndrome. The patient recovered well and was transferred to a nearby hospital for rehabilitation. The patient lived well at home until 11 months postoperatively when she suddenly succumbed to pan-peritonitis caused by intestinal perforation. In literature reviews regarding pseudo-Meigsʼ syndrome and colorectal cancer, refractory ascites and pleural effusion were promptly resolved after the resection of ovarian metastases, and this palliation was long-lasting. Therefore, palliative surgery should be attempted in such patients.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 113 (4), 83-91, 2022-12-25

    Fukuoka Medical Association

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