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Background <p>Meigs' syndrome, characterized by a benign ovarian tumor, ascites, and pleural effusion, often presents a diagnostic challenge due to its clinical mimicry of ovarian malignancy, including elevated CA-125 levels. This systematic review synthesizes current evidence on diagnosis and treatment approaches for Meigs' syndrome in benign cases.</p> Main body <p>A systematic review was conducted following PROSPERO protocol (CRD420251125722), focusing on studies published in 2024. Electronic databases were searched using keywords related to Meigs' syndrome and treatment. Risk of bias assessment was performed using appropriate tools for case reports and case series.</p> <p>Nine articles were included, predominantly case reports and case series. Advanced imaging, particularly 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) with standardized uptake value maximum (SUVmax) and standardized uptake value mean (SUVmean) measurements, showed promise in preoperative differentiation. Surgical removal of the benign ovarian tumor was the primary curative treatment. The median CA-125 level was 187 U/mL, with complete resolution of effusions occurring within 1–2&#xa0;weeks post-surgery.</p> Conclusions <p>Meigs' syndrome is a benign condition with favorable prognosis following surgical intervention. Accurate diagnosis and malignancy exclusion are crucial for appropriate management. A multimodal diagnostic approach combining clinical assessment, biochemical evaluation, advanced imaging, and fluid analysis can significantly reduce misdiagnosis rates and improve patient outcomes.</p>

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Decoding Meigs' syndrome without malignancy: a systematic review of therapeutic strategies

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月29日

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  • Mena Abdalla,
  • Hend Hadawi,
  • Ahmed Khalil

摘要

Background

Meigs' syndrome, characterized by a benign ovarian tumor, ascites, and pleural effusion, often presents a diagnostic challenge due to its clinical mimicry of ovarian malignancy, including elevated CA-125 levels. This systematic review synthesizes current evidence on diagnosis and treatment approaches for Meigs' syndrome in benign cases.

Main body

A systematic review was conducted following PROSPERO protocol (CRD420251125722), focusing on studies published in 2024. Electronic databases were searched using keywords related to Meigs' syndrome and treatment. Risk of bias assessment was performed using appropriate tools for case reports and case series.

Nine articles were included, predominantly case reports and case series. Advanced imaging, particularly 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) with standardized uptake value maximum (SUVmax) and standardized uptake value mean (SUVmean) measurements, showed promise in preoperative differentiation. Surgical removal of the benign ovarian tumor was the primary curative treatment. The median CA-125 level was 187 U/mL, with complete resolution of effusions occurring within 1–2 weeks post-surgery.

Conclusions

Meigs' syndrome is a benign condition with favorable prognosis following surgical intervention. Accurate diagnosis and malignancy exclusion are crucial for appropriate management. A multimodal diagnostic approach combining clinical assessment, biochemical evaluation, advanced imaging, and fluid analysis can significantly reduce misdiagnosis rates and improve patient outcomes.