SÍNDROME DE MEIGS SECUNDARIO A TUMOR DE CÉLULAS DE LA GRANULOSA: REPORTE DE CASO

Belgica Tejada; Yessica Del Cid; Nery Vega; Manuel Abad

Submitted October 28, 2024

Published 2026-02-02

Artículos de Investigación

Vol. 33 No. 1 (2020): Revista Médico Científica

MEIGS SYNDROME SECONDARY TO OVARIAN GRANULOSA CELL TUMOR: CASE REPORT

Belgica Tejada⁺⁻
Yessica Del Cid⁺⁻
Nery Vega⁺⁻
Manuel Abad⁺⁻

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DOI: ND

Published: 2026-02-02

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Abstract

Meigs syndrome is a clinical entity related to a benign-solid fibroma-like ovarian tumor; thecoma, Brenner's tumor, or granulosa tumor; accompanied by ascites and pleural effusion. It is characterized by complete clinical resolution after surgical removal.The case of a 33-year-old female patient with four months of abnormal uterine bleeding, fullness and progressive dyspnea is presented. An abdominal ultrasound found a right adnexal mass dependent on the ovary with characteristics suggestive of malignancy;Chest radiography showed unilateral pleural effusion with negative cytology for malignant cells. The definitive histopathological report of the surgical specimen related to a low-grade estrogen-secreting granulosa cell tumor (GCT).The association of Meigs syndrome with a granulosa cell tumor is rare and has not been reported in Panama.

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References

Meigs J. Fibroma of the ovary with ascites and hydrothorax—Meigs' syndrome. Am. J. Obstet. Gynecol. 1954;67(5):962-987.
Imran H, Haidar F, Akhatar S. Prevalence of Meigs Syndrome [Internet]. 2017 [citado 25 abril 2020]. Disponible en: http://www.pjmhsonline.com/2019/april_june/pdf/656.pdf
Krenke R, Maskey-Warzechowska M, Korczynski P, Zielinska-Krawczyk M, Klimiuk J, Chazan R et al. Pleural Effusion in Meigs’ Syndrome—Exudate? 2015;94(49)
.
DeFriend, D. Ovaries. Clinical Ultrasound [Internet]. 2011 [Citado 23 febrero 2020]; 677–678. Disponible en: doi:10.1016/b978-0-7020-3131-1.00035-3
Medina-Villaseño E, Quezada-Adame I, Oliver-Parra P, Aboites-Lucero J, Neyra-Ortíz E, Pérez-Castro J et al. Tumor pélvico asociado a incremento del CA125 por neoplasia benigna. Presentación de un caso resuelto por vía laparoscópica. Gaceta Mexicana de Oncología. 2011;10(5):311-318.
Kottarathil V, Antony M, Nair I, Pavithran K. Recent Advances in Granulosa Cell Tumor Ovary: A Review. Indian J Surg Oncol. 2012;4(1):37-47.
Young R. Ovarian sex cord-stromal tumors and their mimics. Pathology. 2018;50(1):5-15.
Anton, C., Carvalho, F., Oliveira, E., Maciel, G., Baracat, E. and Carvalho, J., 2012. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses. Clinics, 67(5), pp.437-441.
Crum C, Lee K, Nucci M, Granter S, Howitt B, Parast M et al. Diagnostic Gynecologic and Obstetric Pathology. 3rd ed. Elsevier; 2017; vol 27, 1021.
Park J, Bae J. Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report. J Menopausal Med. 2015;21(1):56.
Taniguchi Y, Nishikawa H, Maeda N, Terada Y. Breathlessness, pleural effusions, fibromas, and Meigs syndrome: look beyond the chest and don't delay!. The Lancet. 2020;395(10223)
.
Horda M, Margaridad T. Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists. Diagn Interv Radiol. 2015;21(4):277–286.
Lheureux S, Gourley C, Vergote I, Oza A. Epithelial ovarian cancer. The Lancet. 2019;393(10177):1240-1253.
DeCherney A, Roman A, Nathan L, Laufer N. Obstetrics & gynecology. 11th ed. United States of America: McGraw-Hill Education.; 2013.
Yamamoto Y, Miyagawa Y, Ehara T, Koyama M, Nakamura S, Takeuchi D et al. Three Cases of Pseudo-Meigs’ Syndrome Secondary to Ovarian Metastases from Colorectal Cancer. Case Reports in Surgery. 2017;:1-8.
Shimazaki J, Tabuchi T, Nishida K, Takemura A, Motohashi G, Kajiyama H et al. Synchronous ovarian metastasis from colorectal cancer: A report of two cases. Oncology Letters. 2016;12(1):257-261.
Mohammed SA, Kumar A. Meigs Syndrome. [Actualizado 2020 Jun 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan [citado el 23 de julio 2020] Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK559322/#article-24920.s1
Lessnau KD. Meigs Syndrome [Internet]. Medscape. 2016 [citado 23 julio 2020]. Disponible en: https://emedicine.medscape.com/article/255450-overview#a5
Danilos J, Micha? Kwa?niewski W, Mazurek D, Bednarek W, Kotarski J. Meigs' syndrome with elevated CA-125 and HE-4: a case of luteinized fibrothecoma. Prz Menopauzalny. 2015;14(2):152-154. [citado el 23 de julio 2020] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498034/#CIT0011
Saha, S., & Robertson, M. Meigs' and Pseudo-Meigs' syndrome. Australasian journal of ultrasound in medicine [Internet]. 2012 [Citado 23 febrero 2020]; 15(1), 29–31. https://doi.org/10.1002/j.2205-0140.2012.tb00140.x
Frías, Z., Rodelgo del Pino, A., Pantoja, M., Rubio, J., Álvarez, J. Tumor de células de la Granulosa. Neoplasia estromal de los cordones sexuales. Revisión de la literatura, a propósito de dos casos clínicos. Rev. chil. obstet. ginecol. [Internet]. 2017 Nov [citado 22 febrero 2020]; 82(5): 579-588. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-75262017000500579&lng=es. http://dx.doi.org/10.4067/s0717-75262017000500579.
Campos S, Pardo I, Vidal R, Vásquez Rodríguez M, Alonso-Baquero M. Tumor de células de la granulosa de tipo adulto [Internet]. Elsevier; 2010 [citado 23 febrero 2020]. Disponible en: https://www.elsevier.es/es-revista-clinica-e-investigacion-ginecologia-obstetricia-7-articulo-tumor-celulas-granulosa-tipo-adulto-S0210573X09001476
Choi, K., Lee, H. J., Pae, J. C., Oh, S. J., Lim, S. Y., Cho, E. Y., & Lee, S. S. Ovarian granulosa cell tumor presenting as Meigs' syndrome with elevated CA125. Korean J Intern Med [Internet], 2005 [Citado 23 febrero 2020]; 20(1), 105–109. Disponible en: https://doi.org/10.3904/kjim.2005.20.1.105
Kortekaas KE, Pelikan HM. Hydrothorax, ascites and an abdominal mass: not always signs of a malignancy - Three cases of Meigs' syndrome. J Radiol Case Rep. 2018;12(1):17-26. 2018 Jan 31. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965394/
Gurumurthy M, Bryant A, Shanbhag S. Effectiveness of different treatment modalities for the management of adult?onset granulosa cell tumours of the ovary (primary and recurrent). Cochrane Database of Systematic Reviews [Internet], 2014 [Citado 23 febrero 2020]; Issue 4. Art. No.: CD006912. Disponible en: doi:10.1002/14651858.CD006912.pub2.
Coll Bujardón, D., González F., López S., González, Y. Tumor adulto de células de la granulosa del ovario: presentación de un caso. AMC [Internet]. 2015 Oct [citado 2020 Mayo 17]; 19(5):489-494. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S102502552015000500008&lng=es.
Gámez-Araujo JJ, Barajas-Figueroa LJ, Kortright-Farías M, de Nova-Chávez H. Tumor de células de la granulosa del adulto: reporte de un caso con manifestación inusual. Ginecol. obstet. Méx. [revista en la Internet]. 2017 Ene [citado 22 febrero de 2020];85(1):38-46. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0300-90412017000100008&lng=es.
Lavazzo, C., Gkegkes, I. D., & Vrachnis, N. Fertility sparing management and pregnancy in patients with granulosa cell tumour of the ovaries. Int. J. Gynecol. Obstet. [Internet]. 2015 [Citado 23 febrero 2020]; Vol 35, 331–335. Disponible en: doi:10.3109/01443615.2014.968107
B.-L.L. Seagle, et al., Ovarian granulosa cell tumor: A National Cancer Database study, Gynecol Oncol [Internet]. 2017 [citado 23 febrero 2020]. Disponible en: dx.doi.org/10.1016/j.ygyno.2017.05.020
Starks D, Chan D. Granulosa-Theca Cell Tumors Treatment & Management. Medscape [Internet]; 2018 [citado 23 febrero 2020]. Disponible en: https://emedicine.medscape.com/article/254489-treatment#showall
Khosla, Divya et al. “Ovarian granulosa cell tumor: clinical features, treatment, outcome, and prognostic factors.” North Am J Med Sci vol. 6,3: p 133-8. 2014. doi:10.4103/1947-2714.128475

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[1] Meigs J. Fibroma of the ovary with ascites and hydrothorax—Meigs' syndrome. Am. J. Obstet. Gynecol. 1954;67(5):962-987.

[2] Imran H, Haidar F, Akhatar S. Prevalence of Meigs Syndrome [Internet]. 2017 [citado 25 abril 2020]. Disponible en: http://www.pjmhsonline.com/2019/april_june/pdf/656.pdf

[3] Krenke R, Maskey-Warzechowska M, Korczynski P, Zielinska-Krawczyk M, Klimiuk J, Chazan R et al. Pleural Effusion in Meigs’ Syndrome—Exudate? 2015;94(49)

[4] .

[5] DeFriend, D. Ovaries. Clinical Ultrasound [Internet]. 2011 [Citado 23 febrero 2020]; 677–678. Disponible en: doi:10.1016/b978-0-7020-3131-1.00035-3

[6] Medina-Villaseño E, Quezada-Adame I, Oliver-Parra P, Aboites-Lucero J, Neyra-Ortíz E, Pérez-Castro J et al. Tumor pélvico asociado a incremento del CA125 por neoplasia benigna. Presentación de un caso resuelto por vía laparoscópica. Gaceta Mexicana de Oncología. 2011;10(5):311-318.

[7] Kottarathil V, Antony M, Nair I, Pavithran K. Recent Advances in Granulosa Cell Tumor Ovary: A Review. Indian J Surg Oncol. 2012;4(1):37-47.

[8] Young R. Ovarian sex cord-stromal tumors and their mimics. Pathology. 2018;50(1):5-15.

[9] Anton, C., Carvalho, F., Oliveira, E., Maciel, G., Baracat, E. and Carvalho, J., 2012. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses. Clinics, 67(5), pp.437-441.

[10] Crum C, Lee K, Nucci M, Granter S, Howitt B, Parast M et al. Diagnostic Gynecologic and Obstetric Pathology. 3rd ed. Elsevier; 2017; vol 27, 1021.

[11] Park J, Bae J. Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report. J Menopausal Med. 2015;21(1):56.

[12] Taniguchi Y, Nishikawa H, Maeda N, Terada Y. Breathlessness, pleural effusions, fibromas, and Meigs syndrome: look beyond the chest and don't delay!. The Lancet. 2020;395(10223)

[13] .

[14] Horda M, Margaridad T. Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists. Diagn Interv Radiol. 2015;21(4):277–286.

[15] Lheureux S, Gourley C, Vergote I, Oza A. Epithelial ovarian cancer. The Lancet. 2019;393(10177):1240-1253.

[16] DeCherney A, Roman A, Nathan L, Laufer N. Obstetrics & gynecology. 11th ed. United States of America: McGraw-Hill Education.; 2013.

[17] Yamamoto Y, Miyagawa Y, Ehara T, Koyama M, Nakamura S, Takeuchi D et al. Three Cases of Pseudo-Meigs’ Syndrome Secondary to Ovarian Metastases from Colorectal Cancer. Case Reports in Surgery. 2017;:1-8.

[18] Shimazaki J, Tabuchi T, Nishida K, Takemura A, Motohashi G, Kajiyama H et al. Synchronous ovarian metastasis from colorectal cancer: A report of two cases. Oncology Letters. 2016;12(1):257-261.

[19] Mohammed SA, Kumar A. Meigs Syndrome. [Actualizado 2020 Jun 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan [citado el 23 de julio 2020] Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK559322/#article-24920.s1

[20] Lessnau KD. Meigs Syndrome [Internet]. Medscape. 2016 [citado 23 julio 2020]. Disponible en: https://emedicine.medscape.com/article/255450-overview#a5

[21] Danilos J, Micha? Kwa?niewski W, Mazurek D, Bednarek W, Kotarski J. Meigs' syndrome with elevated CA-125 and HE-4: a case of luteinized fibrothecoma. Prz Menopauzalny. 2015;14(2):152-154. [citado el 23 de julio 2020] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498034/#CIT0011

[22] Saha, S., & Robertson, M. Meigs' and Pseudo-Meigs' syndrome. Australasian journal of ultrasound in medicine [Internet]. 2012 [Citado 23 febrero 2020]; 15(1), 29–31. https://doi.org/10.1002/j.2205-0140.2012.tb00140.x

[23] Frías, Z., Rodelgo del Pino, A., Pantoja, M., Rubio, J., Álvarez, J. Tumor de células de la Granulosa. Neoplasia estromal de los cordones sexuales. Revisión de la literatura, a propósito de dos casos clínicos. Rev. chil. obstet. ginecol. [Internet]. 2017 Nov [citado 22 febrero 2020]; 82(5): 579-588. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-75262017000500579&lng=es. http://dx.doi.org/10.4067/s0717-75262017000500579.

[24] Campos S, Pardo I, Vidal R, Vásquez Rodríguez M, Alonso-Baquero M. Tumor de células de la granulosa de tipo adulto [Internet]. Elsevier; 2010 [citado 23 febrero 2020]. Disponible en: https://www.elsevier.es/es-revista-clinica-e-investigacion-ginecologia-obstetricia-7-articulo-tumor-celulas-granulosa-tipo-adulto-S0210573X09001476

[25] Choi, K., Lee, H. J., Pae, J. C., Oh, S. J., Lim, S. Y., Cho, E. Y., & Lee, S. S. Ovarian granulosa cell tumor presenting as Meigs' syndrome with elevated CA125. Korean J Intern Med [Internet], 2005 [Citado 23 febrero 2020]; 20(1), 105–109. Disponible en: https://doi.org/10.3904/kjim.2005.20.1.105

[26] Kortekaas KE, Pelikan HM. Hydrothorax, ascites and an abdominal mass: not always signs of a malignancy - Three cases of Meigs' syndrome. J Radiol Case Rep. 2018;12(1):17-26. 2018 Jan 31. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965394/

[27] Gurumurthy M, Bryant A, Shanbhag S. Effectiveness of different treatment modalities for the management of adult?onset granulosa cell tumours of the ovary (primary and recurrent). Cochrane Database of Systematic Reviews [Internet], 2014 [Citado 23 febrero 2020]; Issue 4. Art. No.: CD006912. Disponible en: doi:10.1002/14651858.CD006912.pub2.

[28] Coll Bujardón, D., González F., López S., González, Y. Tumor adulto de células de la granulosa del ovario: presentación de un caso. AMC [Internet]. 2015 Oct [citado 2020 Mayo 17]; 19(5):489-494. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S102502552015000500008&lng=es.

[29] Gámez-Araujo JJ, Barajas-Figueroa LJ, Kortright-Farías M, de Nova-Chávez H. Tumor de células de la granulosa del adulto: reporte de un caso con manifestación inusual. Ginecol. obstet. Méx. [revista en la Internet]. 2017 Ene [citado 22 febrero de 2020];85(1):38-46. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0300-90412017000100008&lng=es.

[30] Lavazzo, C., Gkegkes, I. D., & Vrachnis, N. Fertility sparing management and pregnancy in patients with granulosa cell tumour of the ovaries. Int. J. Gynecol. Obstet. [Internet]. 2015 [Citado 23 febrero 2020]; Vol 35, 331–335. Disponible en: doi:10.3109/01443615.2014.968107

[31] B.-L.L. Seagle, et al., Ovarian granulosa cell tumor: A National Cancer Database study, Gynecol Oncol [Internet]. 2017 [citado 23 febrero 2020]. Disponible en: dx.doi.org/10.1016/j.ygyno.2017.05.020

[32] Starks D, Chan D. Granulosa-Theca Cell Tumors Treatment & Management. Medscape [Internet]; 2018 [citado 23 febrero 2020]. Disponible en: https://emedicine.medscape.com/article/254489-treatment#showall

[33] Khosla, Divya et al. “Ovarian granulosa cell tumor: clinical features, treatment, outcome, and prognostic factors.” North Am J Med Sci vol. 6,3: p 133-8. 2014. doi:10.4103/1947-2714.128475

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