Vol.66 No.4 July 2018
A case report of Pseudo-Meigs' syndrome due to a tuboovarian abscess
1)Department of General Medicine, Ako City Hospital, 1090 Nakahiro, Ako, Hyogo, Japan
2)Department of Gynecology, Kasai City Hospital
Abstract
Tuboovarian abscesses (TOAs) represent an advanced pelvic inflammatory disease. We report for the first time a case of Pseudo-Meigs' syndrome caused by a TOA.
A 51-year-old Japanese woman, gravida 2, para 2, was referred to our hospital, by another hospital with a suspected diagnosis of ovarian cancer. Blood exams at our hospital confirmed the high value of inflammatory reaction and tumor markers including CA 19-9 and CA125.
Imaging studies revealed a huge pelvic mass about 15 cm× 20 cm× 30 cm on the posterior wall of the uterus, suspected as being either ovarian cancer or TOA. Antimicrobial therapies were ineffective with the accumulation of pleural effusion and ascitic fluid during the treatment course. Tumor resection under a laparotomy was performed, and histopathologic examination showed no malignant findings, with a final diagnosis of TOA.
In this case, the TOA had caused Pseudo-Meigs' syndrome. It is necessary to carry out a laparotomy operation to make a definitive diagnosis if imaging studies are insufficient to make an accurate diagnosis. TOA should be considered as a cause of Pseudo-Meigs' syndrome when pleural effusion and ascitic fluid accompany any pelvic mass.
Key word
tuboovarian abscess, ovarian abscess, pleural effusion, ascites
Received
February 9, 2018
Accepted
March 26, 2018
Jpn. J. Chemother. 66 (4): 521-525, 2018
