Pseudo-Meigs' syndrome caused by secondary ovarian tumors from gastrointestinal cancer - A case report and review of the literature

Background: Pseudo-Meigs' syndrome is a condition characterized by nonmalig nant ascites and/or pleural effusion caused by pelvic tumors other than sol id benign ovarian tumors. This syndrome has only rarely occurred in associa tion with gastrointestinal cancers. Method: We treated a 53-year-old woman who developed this syndrome due to ovarian metastasis from colon cancer. Di agnostic work-up for abdominal distension disclosed a sigmoid colon cancer and bilateral ovarian masses. Ultrasonography demonstrated massive ascites and a right pleural effusion. Repeated cytologic examinations of both effus ions revealed no malignant cells. Laparotomy disclosed no peritoneal dissem ination. A radical sigmoidectomy and hysterectomy with bilateral salpingo-o ophorectomy were performed. Results:Histologic examination confirmed ovaria n metastases from the colonic primary tumor. After resection, both effusion s disappeared promptly, confirming a diagnosis of pseudo-Meigs' syndrome ca used by sigmoid colon cancer. The patient remains alive with disease after 52 months. Conclusion: Among 6 reported occurrences with gastrointestinal t umors including our case, the primary site was the colon or rectum in 5 and the stomach in 1. Two cases were due to Krukenberg tumors. Three patients with documented outcomes were alive 108, 52, and 12 months after resection. Clinicians should note that gastrointestinal cancers, especially colorecta l tumors, rarely may cause pseudo-Meigs' syndrome and resection may provide long-term palliation. Copyright (C) 2000 S. Karger AG, Basel.