PP 52. High Level Serum CA125 and Ovarian Fibroma Presenting as Meigs Syndrome Case Report

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E. Bayramov, A Allahverdiyev, R. Abdullayev

18:52 - 18:58h at Lanchid Room

Categories: Poster Session , Surgical Oncology

Session: Poster (P4) - Surgical Oncology

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Background
Elevated serum CA125 levels in postmenopausal women with solid adnexal masses, ascites, and pleural effusion are highly suggestive for malignant ovarian tumor. Meigs' syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after removal of the tumor.

Material and Methods
A 52-year old woman was admitted to hospital because of progressive dyspnea, abdominal distention. Blood chemistry was within normal limits except for a serum CA125 level of 1.270 U/ml. CT of the thorax and abdomen confirmed the pericardial and pleural effusions and also revealed ascites and a 20cm left ovarian mass the chest, abdomen and pelvis were otherwise diseasefree

Result
Due to clinical suspicion of malignant ovarian tumor, the patient was submitted to exploratory laparotomy which revealed 5.000 ml of serous ascites. After aspiration of the ascitic fluid, a 13×10×10cm lobulated right adnexal solid mass without excrescences was found. The serum CA125 level on the sixth postoperative day was 22 U/ml. The pleural effusion was resolved completely on repeat chest X-ray. The patient was asymptomatic with a normal serum CA125 level 6 months after the operation.

Conclusion
The association of massive abdominal ascites, pleural effusion, and pelvic mass with an elevated serum CA125 level portends a poor prognosis. This case illustrates the importance of appropriate surgery to obtain histopathological confirmation of Meigs' syndrome, as a small percentage of patients will have a benign etiology even in the presence of an elevated serum CA125 level.