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Meigsʼ syndrome is characterized by benign ascites and hydrothorax associated with the fibrous neoplasm, generally fibromas of the ovaries. The ascites and hydrothorax resolve by resecting such ovaria...n tumors. The ovarian malignancy and metastatic tumors of the ovaries can also cause the same syndrome with benign hydrothorax and ascites. In such cases, the condition is called pseudo-Meigsʼ syndrome. Herein, we present a successful palliative surgery for pseudo-Meigsʼ syndrome due to a metastatic ovarian tumor from colon cancer. A 79-year-old woman was transferred to our hospital for the treatment of refractory hydrothorax. Computed tomography and colonoscopy revealed ascending colon cancer with lymph node metastases, a large right primary or metastatic ovarian tumor, and massive pleural effusion. The patientʼs general condition gradually worsened toward respiratory failure. Therefore, a rescue operation, including a right hemicolectomy with lymph node dissection, the resection of peritoneal dissemination, and the resection of the ovarian tumor, was performed. The amount of pleural effusion markedly decreased after the operation, and the patient was diagnosed with pseudo-Meigsʼ syndrome. The patient recovered well and was transferred to a nearby hospital for rehabilitation. The patient lived well at home until 11 months postoperatively when she suddenly succumbed to pan-peritonitis caused by intestinal perforation. In literature reviews regarding pseudo-Meigsʼ syndrome and colorectal cancer, refractory ascites and pleural effusion were promptly resolved after the resection of ovarian metastases, and this palliation was long-lasting. Therefore, palliative surgery should be attempted in such patients.
Meigs 症候群は，線維性腫瘍，一般的には卵巣の線維腫に伴う良性の腹水・胸水が特徴であり，卵巣腫瘍を切除することによって消失する．卵巣の悪性腫瘍や卵巣の転移性腫瘍も同様に良性の腹水・胸水を伴う同じ症候群を引き起こすことがある．そのような病態はpseudo-Meigs 症候群といわれる．今回われわれは，大腸癌の転移性卵巣腫瘍によるpseudo-Meigs 症候群に対する緩和手術の成功例を報告する．症例は79歳女性で，難治性胸水の治療のため当院に転院してきた．CT検査と大腸内視鏡検査により，リンパ節転移を伴う上行結腸癌，巨大な右原発卵巣腫瘍，または転移性卵巣腫瘍，大量胸水貯留の診断となった．呼吸不全の増悪により全身状態は徐々に悪化した．そこで，救命目的でリンパ節郭清を伴う結腸右半切除術，腹膜播種切除術，卵巣腫瘍切除術を施行した．術後，胸水量は著明に減少し，pseudo-Meigs 症候群と診断した．患者は順調に回復し，リハビリのため近医に転院した．その後，術後11ヶ月目に腸管穿孔による汎発性腹膜炎で死亡した．pseudo-Meigs 症候群と大腸癌に関する文献では，難治性の腹水・胸水が卵巣転移巣の切除により速やかに消失し，その緩和効果は長期に及んでいる．従って，このような患者に対しては緩和手術を試みるべきである．続きを見る
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Mendeley出力
113-4_p083