Pathology Notes

Meigs syndrome Updated: 05/20/2020 © Jun Wang, MD, PhD General features Triad Benign ovarian tumor, ovarian fibromas most common, may be seen with thecoma , granulosa cell tumor as well Ascites Pleural effusion Ascites and pleural effusion disappear after tumor removal Unclear pathophysiology, probably lymphatic drainage of irritation/secretion associated ascite Diagnosis of exclusion after ovarian cancer ruled out Clinical presentations Associated with ovarian tumor: mass, etc Associated with pleural effusion: Dullness of percussion, tachypnea, etc Associated with ascites: shifting dullness, etc Management Rule out malignancy Symptomatic support Surgical removal of ovarian tumor Back to syndromes Back to contents

Practice questions IV, female genital tract Pathology of ovary B © Jun Wang, MD, PhD 1. Use this case for the next five questions. A 51-year-old woman presents with vague left lower abdominal pain for 2 months. She denies other symptoms. She has a history of endometriosis that was treated with oral contraceptives. She has multiple squamous cell carcinoma of skin during the past ten years and was treated with local resection. She smokes cigarette 1 pack a day for 25 years and drinks 1 glass of wine per day for 20 years. Physical examination reveals a firm mass at her left adnexa. Image studies reveals a 3.5 cm solid and cystic mass at her left ovary and a 1.2 cm cystic lesion at her right ovary. Bilateral oophorectomy was performed. Microscopically, the right ovarian lesion has tubular gland lined by benign appearing columnar cells with no mucin production. There are signs of old hemorrhage but no cytological atypia is noted. The left ovarian mass has complex gla...