Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2021; 9(18): 4734-4740
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4734
Meigs’ syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions: A case report
Xiao-Juan Wu, Hang-Biao Xia, Bao-Lin Jia, Gao-Wu Yan, Wen Luo, Yong Zhao, Xiao-Bin Luo
Xiao-Juan Wu, Hang-Biao Xia, Wen Luo, Yong Zhao, Xiao-Bin Luo, Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suining 629000, Sichuan Province, China
Bao-Lin Jia, Department of Oral and Maxillofacial Surgery, Suining Central Hospital, Suining 629000, Sichuan Province, China
Gao-Wu Yan, Department of Radiology, Suining Central Hospital, Suining 629000, Sichuan Province, China
Author contributions: Wu XJ and Xia HB treated the patient and drafted the manuscript; Luo XB critically reviewed and revised the manuscript; Jia BL, Zhao Y, Luo W, and Yan GW assisted in analyzing the case and processing the images; all authors have read and approved the final manuscript.
Supported by the Scientific Research Project of Sichuan Provincial Health and Family Planning Commission, No. 18PJ409.
Informed consent statement: Written informed consent for publication and any accompanying images was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests with regard to publication of this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Bin Luo, PhD, Chief Doctor, Department of Respiratory and Critical Care Medicine, Suining Central Hospital, No. 127 Deshengxilu Road, Suining 629000, Sichuan Province, China. 415322095@qq.com
Received: September 30, 2020
Peer-review started: September 30, 2020
First decision: March 27, 2021
Revised: April 5, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 26, 2021
Abstract
BACKGROUND

Meigs’ syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites, both of which resolve after removal of the tumor. Patients often seek treatment in the Department of Respiratory and Critical Care Medicine or other internal medicine departments due to symptoms caused by ascites or hydrothorax. Here, we report a rare case of Meigs' syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions.

CASE SUMMARY

A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath. Chest X-ray and chest computed tomography showed a modest volume of pleural fluid with pleural thickening in the right lung. The carbohydrate antigen 125 (CA125) concentration was 150.8 U/mL (normal, 0-35 U/mL) and no tumor cells were observed in pleural fluid. Nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a ‘string of beads’-like appearance in the diaphragm were found by thoracoscopic examination. Furthermore, pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm × 10.0 cm × 12.4 cm with heterogeneous signal intensity and multiple hypointense separations. Total abdominal hysterectomy, bilateral adnexectomy, and separation of pelvic adhesion were performed under general anesthesia. The pathology results showed granulosa cell tumor. At the 2-mo follow-up after the surgery, the hydrothorax subsided, and the CA125 level returned to normal.

CONCLUSION

For postmenopausal women with unexplained hydrothorax and elevated CA125, in addition to being suspected of having gynecological malignancy, Meigs’ syndrome should be considered.

Keywords: Meigs’ syndrome, Granulosa cell tumor, Hydrothorax, Ascites, Carbohydrate antigen 125, Case report

Core Tip: A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath. Chest X-ray and chest computed tomography showed pleural fluid in the right lung. The carbohydrate antigen 125 (CA125) concentration was elevated. This is the first case in which nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a ‘string of beads’-like appearance in the diaphragm were revealed by thoracoscopic examination. Pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm × 10.0 cm × 12.4 cm and the pathology results showed granulosa cell tumor. After the surgery, the hydrothorax subsided, and the CA125 level returned to normal.