Introduction: Meigs syndrome is defined by the presence of an ovarian benign tumor, ascites, and pleural effusion. The restoration of normal conditions following the removal of the ovarian mass is typical. Although an increase in CA 125 has been reported in association with Meigs syndrome, a level above 1000 IU/mL is unusual, and there is no clear association between patients’ or tumor/cancer characteristics and CA 125 increment to the best of our knowledge. Materials and methods: We conducted a review of Meigs syndrome cases associated with high CA 125 levels and then divided and compared all cases found in the literature and the one described in the text, taking into account the increase of CA 125 = 1000 IU/mL, to identify any possible factor influencing the CA 125 increase. Results: A 55-year-old woman with Meigs syndrome (hydrothorax, ovarian fibroma, and ascites) presented CA 125of 1713 IU/mL. In our review, we found 43 articles that collected 55 cases of Meigs syndrome with an increase inCA 125 of 25% or more than 1000 IU/mL. Considering two groups, divided considering the CA 125 value of 1000IU/mL, we found that the presence of bilateral masses and ascites over 2 L represented independent risk factors for high elevation of CA 125. Conclusion: The presence of bilateral mass and an increase in ascites were associated with an increase in CA125 of 1000 IU/mL, which could be useful in maintaining a benign lesion hypothesis even if the definitive diagnosis could not be made until after surgery, at histological evaluation. 

Meigs syndrome: a case report and literature review

Introduction: Meigs syndrome is defined by the presence of an ovarian benign tumor, ascites, and pleural effusion. The restoration of normal conditions following the removal of the ovarian mass is typical. Although an increase in CA 125 has been reported in association with Meigs syndrome, a level above 1000 IU/mL is unusual, and there is no clear association between patients’ or tumor/cancer characteristics and CA 125 increment to the best of our knowledge. Materials and methods: We conducted a review of Meigs syndrome cases associated with high CA 125 levels and then divided and compared all cases found in the literature and the one described in the text, taking into account the increase of CA 125 = 1000 IU/mL, to identify any possible factor influencing the CA 125 increase. Results: A 55-year-old woman with Meigs syndrome (hydrothorax, ovarian fibroma, and ascites) presented CA 125 of 1713 IU/mL. In our review, we found 43 articles that collected 55 cases of Meigs syndrome with an increase in CA 125 of 25% or more than 1000 IU/mL. Considering two groups, divided considering the CA 125 value of 1000 IU/mL, we found that the presence of bilateral masses and ascites over 2 L represented independent risk factors for high elevation of CA 125. Conclusion: The presence of bilateral mass and an increase in ascites were associated with an increase in CA 125 of 1000 IU/mL, which could be useful in maintaining a benign lesion hypothesis even if the definitive diagnosis could not be made until after surgery, at histological evaluation 

Pregnancy is the most wonderful experience of a woman’s life. A mother’s physical fitness is just as important as her mental health. A non-experimental and correlational study was conducted to examine the relationship between mothers’ psychosocial status and pregnancy outcome among 50 antenatal mothers in their third trimester. The aim of the study is to assess the psychosocial status of antenatal care (ANC) mothers, assess the pregnancy outcome, and find out the correlation between psychosocial status and pregnancy outcome. Result: In this study, using the ALPHA scale to assess the psychosocial status of antenatal mothers, the majority of them had a higher psychosocial score, and some had a middle psychosocial score, but none had a low psychosocial score. Conclusion: From this study, we conclude that there was an association between psychosocial status and pregnancy outcome.

/pdf/a-study-to-examine-the-relationship-between-mothers-1dln1b9q.pdf

A Study to Examine the Relationship Between Mothers’ Psychosocial Status and Pregnancy Outcome

Abstract Hydropic leiomyoma (HLM) is one of the rare subtypes of uterine leiomyoma. HLM is characterized by diffuse water degeneration and often secondary cystic changes. While HLM enlarged rapidly, especially with hydrothorax and ascites, they were often misdiagnosed as malignant tumors. Pseudo-Meigs’ syndrome is characterized by the presence of hydrothorax and ascites associated with pelvic masses (benign or malignant). Pseudo-Meigs’ syndrome presenting with elevated serum cancer antigen-125 (CA125) is rare and very likely misdiagnosed as a malignancy of the uterus or ovary. Pseudo-meigs’ syndrome with CA125 elevation caused by hydropic leiomyoma is rarer. Here, we reported a 45-year-old Chinese female with ascites, right hydrothorax and a rapidly enlarging pelvic mass. Preoperative abdominal and pelvic CT showed a giant solid mass in the fundus uteri, measuring 20×15×12 cm. The tumor marker CA125 was found to be elevated to 247.7 U/ml and 304.60 U/ml in serum and hydrothorax, respectively. She was initially diagnosed of uterine malignancy and underwent total abdominal hysterectomy and adhesiolysis. The final pathological diagnosis of the specimen was uterine hydropic leiomyoma with cystic changes. After the tumor removal, the ascites and hydrothorax disappeared rapidly and without recurrence. The serum CA125 dropped to 116.90 U/mL on day 7 and 5.6 U/mL on day 40. Follow-up was obtained at 6 months, 1 year, and 2 years after surgery, respectively. The patient's physical signs were all normal, with no recurrence of ascites or hydrothorax. 

Pseudo-Meigs’ syndrome caused by rapidly enlarging hydropic leiomyoma with elevated CA125 mimicking ovarian malignancy: A case report and literature review

Background: An increased CA 125 in conjunction with a pelvic mass is, although, strongly indicative of ovarian cancer, there are a number of other benign diseases that may be linked to a pelvic mass and a higher CA 125. Meigs syndrome is an uncommon condition in women under the age of 30. It consists of a triad of benign fibrous ovarian tumors, ascites, and pleural effusion. When the tumor is removed, the symptoms got resolve completely within two weeks. Case Presentation: It is a case of a 15-year-old girl with fibroma, along with a review of the literature. Although the cause of the fluid accumulations is unknown, it seems to be linked to lymphatic blockage. Abdominal distension, pain, cough, pleuritic chest pain, vomiting, fever, and weight loss are all presenting symptoms. Conclusion: This case report concludes that although a pelvic mass with elevated CA 125 is strongly indicative of malignancy, other illnesses, particularly Meigs syndrome and pseudo-Meigs syndrome in young women presenting with a pleural effusion, should always be evaluated as a differential diagnosis. The fluid buildup typically disappears within two weeks of the tumor being removed.

Meig's Syndrome with an Elevated CA125 in a 15-Year-old Girl

A 44-year-old woman presented with 3 months’ history of painless progressive abdominal distension and weight loss of more than 15 kg. Clinically a pelviabdominal mass with ascites was detected. CT scan of the pelvis and abdomen showed a subserosal leiomyoma with huge amount of ascites. Cancer Antigen (CA)-125 was 546 kU/L. Exploratory laparotomy with myomectomy was done and this was followed by dramatic improvement postoperatively.

/pdf/massive-ascites-pelvic-mass-elevated-ca-125-and-weight-loss-4gdv2492dz.pdf

Massive ascites, pelvic mass, elevated CA-125 and weight loss: think outside the 'ovaries'

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Massive ascites, pelvic mass, elevated CA-125 and weight loss: think outside the 'ovaries'