Uterine leiomyoma with associated pseudo-Meigs syndrome mimicking ovarian carcinoma
Landrum, L.M.; Rutledge, T.L.; Osunkoya, A.O.; Mannel, R.
Journal of the Oklahoma State Medical Association 101(2): 38-39
2008
ISSN/ISBN: 0030-1876 PMID: 18361033 Document Number: 620761
Uterine leiomyoma are commonly diagnosed in women of reproductive age. However, these benign tumors may present with clinical signs and symptoms that are consistent with ovarian carcinoma. A 47-year-old gravida 0 presented with a large pelvic mass, ascites, bilateral pleural effusions, and an elevated CA 125 worrisome for ovarian carcinoma. Exploratory laparotomy revealed a 20,120 g pelvic mass, with 2 L ascites, and pelvic and periaortic lymphadenopathy. Final pathology was consistent with a benign giant leiomyoma. Postoperative course was complicated by reaccumulation of pleural effusion requiring therapeutic thoracentesis and diuretics. Patient had return to full activity with 50 pound weight loss at 8 weeks after surgery. Elevated CA 125 levels and ascites are often associated with ovarian carcinoma, but it is also important to keep benign processes in the differential diagnosis when considering malignancy.