Meigs's syndrome

Lore & Background

Meigs's syndrome is characterized by the presence of a benign solid ovarian tumor associated with ascites and right hydrothorax that disappear after tumor removal. The pleural effusion is classically on the right side because the transdiaphragmatic lymphatic channels are larger in diameter on the right. The causes of the ascites and pleural effusion are poorly understood. An atypical form exists, with a benign pelvic mass and right-sided pleural effusion but without ascites, which also resolves after removal of the mass.

Reader's Guide

Meigs's syndrome is significant in clinical medicine because it presents with symptoms that mimic ovarian malignancy and other serious conditions, including various gynecological disorders and non-gynecological entities such as cirrhosis, tuberculosis, and congestive heart failure. The key distinguishing feature is that the underlying tumor is benign, and the associated fluid accumulations resolve completely after tumor resection. Diagnosis requires clinical exclusion of other causes of pelvic mass, ascites, and pleural effusion. Treatment involves draining excess fluid via thoracentesis and paracentesis, followed by unilateral salpingo-oophorectomy or wedge resection. The syndrome's eponym honors Joe Vincent Meigs. Its recognition helps avoid unnecessary aggressive treatment for a benign condition.

Did You Know?

• The pleural effusion in Meigs syndrome is classically on the right side due to larger transdiaphragmatic lymphatic channels on the right.
• Atypical Meigs syndrome presents with a benign pelvic mass and right-sided pleural effusion but without ascites.
• The causes of the ascites and pleural effusion in Meigs syndrome are poorly understood.
• Meigs syndrome resolves after resection of the tumor.