Laparoscopic Resection of a Subserosal Leiomyoma Presenting as Pseudo–Meigs' Syndrome

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Abstract
Background: The clinical triad presentation of a benign ovarian tumor (fibroma, thecoma, granulosa-cell tumor), ascites, and hydrothorax that resolve after removal of the aforementioned tumor characterize Meigs' syndrome. A similar presentation of ascites and hydrothorax coexisting with other benign cysts or teratomas of the ovary or leiomyomas of the uterus, are referred to as pseudo–Meigs' syndrome. Uterine leiomyomas rarely cause pseudo-Meigs' syndrome with elevated serum cancer antigen (CA)–125 levels. Case: A 38-year-old woman was initially diagnosed with a large left ovarian tumor. Intraoperatively, this tumor was revealed to be a subserosal leiomyoma with ascites, mimicking pseudo–Meigs' syndrome. Results: The leiomyoma was resected laparoscopically. Operating time was 60 minutes and resection was carried out with a 150-mL blood loss. The postoperative period was uneventful, and the patient was discharged as well on postoperative day 3. Conclusions: Uterine leiomyomas presenting as pseudo-Meigs should be considered as a differential diagnosis for large pelvic masses with ascites and elevated CA-125 levels. In such situations, laparoscopic myomectomy is feasible. (J GYNECOL SURG 36:222)

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