Chủ Nhật, 12 tháng 1, 2014

Meigs Syndrome

Meigs Syndrome Meigs syndrome is marked by the presence of ovary tumor (mostly harmless), ascites and pleural effusion. People with this syndrome will have parents or other members of the family with ovarian cancer. Ovarian tumor is more popular in women belonging to upper economic groups. Meigs syndrome can become a fibroma if the tumor is removed surgically. This syndrome is often benign (harmless) and can be managed properly.


Ovarian tumor appears in the late 30’s and continues to develop and incidence of cases with this syndrome has been reported with age group 50-70 also.


Symptoms :


Not the symptoms are the same for all women but it can differ depending on the intensity of the tumor formed in the ovary. The affected women can have larger abdomen, weight gain (due to the prospective growth of the tumor), and bloated sensation. There can be missing periods or recurring periods in some women. It can cause nonproductive cough and shortness of breath also.


In severe cases, there can be pleural effusion on the right side of the lungs and sometimes on both the sides and clinical observation of the abdomen will indicate solid pelvic mass.


Causes :


Ovarian tumor and ascites are caused by several reasons. It can occur due to low levels of albumin, high blood pressure in the liver, and any type of liver disease like cirrhosis and hepatitis B infection. Certain medical conditions like congestive heart failure, pancreatitis, having clots in the veins of liver and thickening of outer sac of the heart can also cause Meigs syndrome.


Old age can increase the risk of getting ovarian tumor. Women in the menopause stage are prone to get ascitis and tumor in the ovary. Obesity, diabetes and smoking can also trigger formation of tumor. Prolonged use of oral contraceptive pills and undergoing hormone therapy can increase the risk of this syndrome. More than 75% of the patients diagnosed with cirrhosis will have ascities. Hyperthyroidism, elevated levels of CA 125 and struma ovary can also cause Meig’s syndrome.


Diagnoses :


Your doctor will examine your body physically and order for CBC count and basic metabolic profile. CBC count gives the right level of hemoglobin to detect if anemia is present. Levels of sodium potassium, creatinine and blood urea are also examined. Serum cancer antigen 125 test is done in case of suspicion. In addition computer topographic scan of the pelvis and abdomen are done. If the patient has signs of breathlessness, ECG is taken for detecting heart functions.


Treatment :


Your doctor will first have to look for the underlying causes for treating Meigs syndrome. For patients with cirrhosis salt intake will be restricted. Diuretic medications like spironolactone are prescribed. For women with refractory ascites taking therapeutic paracentesis will be beneficial and the procedure needs to be made in sterile environment.


Alternatively TIPS transjugular intrahepatic porotsystemic shunt is done for refractory ascites and the procedure of paracentesis is to be done for every 4 months. Doing paracentesis will give temporary relief from the symptoms and shunts are effective for managing malignant ascites. For mild forms of ovarian cyst no treatment is required but your doctor will have to monitor your pelvis regularly for any changes.


Surgery :


Laparoscopy is a procedure in which small incision is made on the abdomen for removing the cyst surgically. It is effective for treating small sized cysts which are benign. Laparotomy is done for removing large sized cyst or ovarian tumors. For malignant type of tumors, chemotherapy is done in which drugs are given directly into the stomach for killing cancer cells. But this procedure will have side effects like nausea, vomiting, kidney disease and risk of getting infection.


Radiation therapy is effective in shrinking cancer cells in the ovary. Customized treatment and therapy is given based on the health condition and intensity of the tumor involved. Women in the post-menopause stage will undergo bilateral salpingo oopherectomy or total hysterectomy depending on the situation. For women in the reproductive stage unilateral salpingo oophorectomy is done.


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