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Pseudo-Meigs syndrome is a clinical triad of:
- Ovarian or pelvic tumor (other than fibroma/fibrothecoma).
- Ascites.
- Pleural effusion.
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The condition mimics Meigs syndrome, but differs in that the underlying tumor is not an ovarian fibroma, fibrothecoma, or Brenner tumor, but rather another ovarian or pelvic tumor (often malignant).
Etiopathogenesis
- Age: Seen in adult women; incidence depends on tumor type.
- Etiology:
- Classically associated with ovarian neoplasms other than fibroma, e.g.:
- Ovarian malignancies (serous/mucinous cystadenocarcinoma, granulosa cell tumor).
- Metastatic tumors (Krukenberg tumor).
- Struma ovarii (rarely).
- Pathophysiology:
- Ascites likely due to irritation of peritoneum and fluid transudation.
- Pleural effusion results from passage of ascitic fluid through transdiaphragmatic lymphatic channels (usually right-sided).
Clinical Features
- Abdominal distension (ascites).
- Respiratory distress (pleural effusion, usually right-sided).
- Palpable adnexal mass.
- Symptoms mimic advanced ovarian carcinoma.
Radiology
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In pseudo-Meigs syndrome, effusions resolve completely after tumor resection – this is diagnostic and distinguishes it from true metastatic disease.
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| Modality |
Imaging features |
| US |
• Adnexal mass (may be benign or malignant). |
| • Associated ascites. |
|
| • Pleural effusion can be picked up if suspected. |
|
| CT/MR |
• Complex ovarian/pelvic mass (may be solid, cystic, or mixed depending on type). |
| • Ascites of variable volume. |
|
| • Pleural effusion (better seen on chest imaging). |
|
Differentials
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Key challenge: Differentiating pseudo-Meigs syndrome from peritoneal carcinomatosis with pleural metastases.
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- Meigs syndrome – Triad due to ovarian fibroma/fibrothecoma/Brenner tumor.