A Case of Ovarian Fibromatosis and Massive Ovarian Oedema Associated With Intra-Abdominal Fibromatosis, Sclerosing Peritonitis and Meig’s Syndrome

Emma L Spurrell,Ian R Judson,Terence P Rollason,Yen C Yeo

doi:10.1155/2004/319730

Abstract

Purpose:To discuss a case of ovarian fibromatosis/massive ovarian oedema, intra-abdominal fibromatosis, sclerosing peritonitis and Meig’s syndrome. To review the reported therapeutic options.Patients:Case report of a 27-year-old female with the combined pathology of ovarian fibromatosis/massive ovarian oedema, intra-abdominal fibromatosis, sclerosing peritonitis and Meig’s syndrome.Methods:This patient was treated with supportive care and cytotoxic chemotherapy.Results:Despite the benign nature of the ovarian pathology, this patient presented with life-threatening complications. Response to treatment was probably multi-factorial combining the effects of cytotoxics, use of steroids and good supportive care. She remains in complete remission 4 years post completion of chemotherapy.Conclusion:There are reports in the literature of ovarian fibromatosis/massive ovarian oedema, luteinised thecomas, intraabdominal fibromatosis and Meig’s syndrome occurring together in a variety of combinations. Treatment has been described with radiotherapy, cytotoxic and non-cytotoxic chemotherapy regimens. This case provides a link between ovarian fibromatosis/massive ovarian oedema, intra-abdominal fibromatosis, sclerosing peritonitis and Meig’s syndrome not previously described.

Highlights

Fibromatosis describes a group of fibrous tissue proliferations that, benign, can be locally invasive but do not metastasise.[1]
They demonstrate the histopathological changes seen in massive ovarian oedema, ovarian fibromatosis, sclerosing peritonitis and intra-abdominal fibromatosis
This paper suggested that the addition of radiotherapy to surgery improved local control rates for post-operative negative surgical margins (72 vs. 94% with addition of radiotherapy) and positive surgical margins (41 vs. 75% with addition of radiotherapy).[13]

Summary

Presentation of case

At the end of July 1999 a third laparotomy was undertaken for persistent small bowel obstruction and clinical evidence of recurring mass in the abdomen. On admission to RMH the patient was clinically stable but requiring on-going TPN for persistent small bowel obstruction. The obstructive GI symptoms persisted and the patient remained dependent upon TPN. In May 2000, 11 months following admission to the referring hospital, the patient was discharged home Imaging at this time showed virtual complete resolution of effusions, small volume ascites, significant reduction in peritoneal disease, hepatosplenomegaly and no evidence of GI obstruction. They demonstrate the histopathological changes seen in massive ovarian oedema, ovarian fibromatosis, sclerosing peritonitis and intra-abdominal fibromatosis.

Introduction

Not stated

Findings

Conclusion