Pseudo-Meigs' Syndrome with Degenerative Uterine Leiomyoma in Pregnancy

Abstract

Summary Objective Uterine leiomyomas rarely cause pseudo-Meigs' syndrome. We describe a case of pseudo-Meigs' syndrome during pregnancy. Case Report A 35-year-old woman (gravida 0, para 0) experienced rapid abdominal distension over a period of 1 week in the first trimester. She had had an adnexal mass of 7 × 6 cm for 5 years but continued to have regular menstrual cycles. Serial imaging showed slow progressive enlargement of the adnexal mass but serum CA-125 levels remained normal. Ultrasonography showed a large solid mass that was 25 × 20 × 20 cm in size, with a uterine gestational sac and massive ascites. Both ovaries appeared normal and a small amount of pleural effusion was detected. CA-125 levels increased to 558.11 kU/L and exploratory laparotomy was performed. During surgery, the solid mass was found to be a pedunculated leiomyoma originating from the uterine fundus, with 3,200 mL of clear yellowish ascites. Myomectomy was performed and microscopic examination showed a leiomyoma with degenerative changes. The patient received regular prenatal examinations in outpatient clinics after discharge; a healthy female baby was delivered at term. Conclusion Pseudo-Meigs' syndrome was diagnosed when hydrothorax and ascites occurred with a pelvic mass other than ovarian fibroma. Pregnancy may aggravate the syndrome.