Meigs’ Syndromes with Extremelly High CA125 Level Mimicking Advanced Ovarian Cancer

Abstract

Meigs' syndrome is defined as pelvic mass with ascites and pleural effusion which can mimic ovarian malignancy. Additionally, elevated serum CA125 level can be seen in Meigs' syndrome. We present 2 cases with solid adnexal mass, ascites and bilateral pleural effusion with high serum CA125 level (2824 IU/mL and 1400 IU/mL) which were diagnosed as ovarian malignancy preoperatively. In both cases level of CA125 were extremely high for Meigs’ syndrome and high level of CA125 in Meigs’ Syndrome is unusual. Solid adnexal mass and serous ascites was detected in explorative laparotomy in 2 cases also. Other genital and abdominal structures were normal. In both cases the right salpingo oophorectomy was performed. In addition, the ovarian fibroma was reported in one case and nonspecific for other case during frozen/section examination. Contralateral salpingo-oophorectomy and total hysterectomy was performed because of the age of patients in one case and non- diagnostic frozen section examination in the other case. Final pathology confirmed the diagnosis of ovarian fibroma in first case and thecoma in the second one. Despite the suggestion of ovarian malignancy in preoperative period, the frozen/section
examination is the mainstay in the management of adnexal masses.