Ovarian dysgerminoma with pseudo-Meigs syndrome: A case report

Medicine (Baltimore). 2021 Jun 11;100(23):e26319. doi: 10.1097/MD.0000000000026319.

Abstract

Rationale: Dysgerminoma is a rare malignant tumor of the ovary, more frequently occurring in young women. The main signs of pseudo-Meigs syndrome (PMS) are ascites and hydrothorax accompanying benign or malignant ovarian tumors (no fibroma or fibroma-like tumor).

Patient concerns: A 19-year-old woman with fever and chest tightness for 2 days.

Diagnoses: Pectoral-abdominal computed tomography (CT) scan and contrast-enhanced magnetic resonance imaging revealed a large amount of right pleural effusion, a small amount of ascites, and a huge abdominopelvic mass measuring about 29.2cm × 11.8cm × 8.4 cm in the left ovary. The result of hydrothorax examination was consistent with the diagnosis of exudative pleural effusion. In addition, Rivalta-test showed a positive result and lactate dehydrogenase was elevated. The histopathological diagnosis was a giant germ cell tumor, which was consistent with dysgerminoma in terms of both morphology and immunophenotype. Based on these findings, a diagnosis of malignant ovarian neoplasm with PMS was made.

Interventions: Surgical resection of the tumor was performed.

Outcomes: The patient recovered well after operation, and the pleural effusion and abdominal ascites vanished. No recurrence was observed during the 1-year follow-up period.

Lessons: Ovarian dysgerminoma with PMS is a rare malignant tumor of the ovary, which often occurs in young women. It should be considered in differential diagnosis of patients with a pelvic mass, ascites and pleural effusion. Early diagnosis and surgical treatment are beneficial to prolonged survival.

Publication types

  • Case Reports

MeSH terms

  • Ascites* / diagnostic imaging
  • Ascites* / etiology
  • CA-125 Antigen / blood
  • Diagnosis, Differential
  • Dysgerminoma* / blood
  • Dysgerminoma* / pathology
  • Dysgerminoma* / physiopathology
  • Dysgerminoma* / surgery
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Magnetic Resonance Imaging / methods
  • Meigs Syndrome / diagnosis*
  • Neoplasm Staging
  • Ovarian Neoplasms* / blood
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / physiopathology
  • Ovarian Neoplasms* / surgery
  • Ovariectomy / methods*
  • Pleural Effusion* / diagnostic imaging
  • Pleural Effusion* / etiology
  • Radiography, Thoracic / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Young Adult

Substances

  • CA-125 Antigen
  • L-Lactate Dehydrogenase