J Breast Cancer.  2012 Dec;15(4):474-477. 10.4048/jbc.2012.15.4.474.

A Case of Pseudo-Meigs' Syndrome Associated with Ovarian Metastases from Breast Cancer

• Naito K
• Oura S
• Yasuoka H
• Okamura Y

• KMID: 2286447
• DOI: http://doi.org/10.4048/jbc.2012.15.4.474

Abstract

A 54-year-old woman with long-lasting pleural effusion developed abdominal distention due to ascites from bilateral ovarian tumors. The patient had undergone breast-conserving surgery and axillary lymph node dissection for left breast cancer in October 2000, and had developed left pleural effusion in July 2006. Cytological examination of the pleural effusion found no malignant cells. Thoracic drainage with intrathoracic administration of OK-432 (Picibanil) had failed to control the pleural effusion. Positron emission tomography taken at the abdominal distention showed bilateral ovarian tumors. After failure to control the ascites with systemic and intra-abdominal chemotherapy, bilateral oophorectomy resulted in normalization of elevated serum tumor-marker levels and the disappearance of both the ascites and pleural effusions (i.e., pseudo-Meigs' syndrome). Pathological examination showed the tumors to be estrogen receptor-positive metastatic ovarian tumors from her breast cancer. The patient remained well with no further recurrence for 40 months under aromatase inhibitor therapy.

Keyword

Breast neoplasms; Ovarian metastasis; Ovariectomy; Pseudo-Meigs' syndrome

MeSH Terms

Aromatase
Ascites
Breast
Breast Neoplasms
Drainage
Estrogens
Female
Humans
Lymph Node Excision
Mastectomy, Segmental
Neoplasm Metastasis
Ovariectomy
Picibanil
Pleural Effusion
Positron-Emission Tomography
Recurrence
Aromatase
Estrogens
Picibanil

Figure

• 

  Figure 1 Chest computed tomography (CT). (A) Chest CT before thoracic drainage. Massive pleural effusion in the left thorax causing deviation of the mediastinum. (B) Chest CT after bilateral oophorectomies. The pleural effusion disappeared completely.

• 

  Figure 2 Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 15-3 levels. CEA and CA 15-3 levels decreased sharply within the normal upper limits after bilateral oophorectomies.

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  Figure 3 Pelvic computed tomography at abdominal distention showing a large mass (arrow) and ascites in the pelvic cavity.

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  Figure 4 Pathological examinations. (A) Tumors were composed of solid and luminal structures (H&E stain,×100). (B) Tumors were highly estrogen receptor-rich (immunohistochemistry,×100). (C) Gross cystic disease fluid protein-15 was highly positive, especially in the luminal part of the tumor (immunohistochemistry, ×100).

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