Zusammenfassung
Eine Patientin mit dem Rezidiv eines Meigs-Syndroms 5 Jahre nach bilateraler Ovarektomie und Hysterektomie wird vorgestellt.
Die Ergüsse in Pleura- und Perikardhöhle zeigen sich therapieresistent gegenüber Drainagetherapie und Talkum-Pleurodese. Eine Perikardfensterung wird bei Perikarderguss und Pericarditis constrictiva notwendig.
Thorakoskopisch gesicherte pleurale Veränderungen werden beschrieben und diskutiert.
Das vorher normalwertige CA-125 steigt auf das Dreifache der Norm an. Die Patientin verstirbt an den Folgen eines rezidivierenden Meigs-Syndroms ohne Nachweis eines Tumorrezidivs.
Hypothesen zum Pathomechanismus des Rezidivs werden vorgestellt. Auf die Notwendigkeit der Gewinnung von pleuralen und peritonealen Biopsien mit nachfolgender immunhistologischer Aufarbeitung zur weiteren Klärung des noch wenig erforschten Meigs-Syndroms wird hingewiesen.
Abstract
A female patient is presented with a relapse of a Meigs syndrome five years after bilateral ovarectomy and hysterectomy.
Discharges in the pleural and pericardial cavity are therapy resistant to drain therapy and talcum pleurodesis. With pericardial discharge and pericarditis constrictiva a pericardial fenestration becomes necessary.
Pleural changes verified by thoracoscopy are described and discussed. The previously normal CA-125 count rose to three times the norm. The patient died from a relapse of the Meigs syndrome without proof of tumor relapse.
Hypotheses of the relapse pathomechanism are discussed. The necessity of pleural and peritoneal biopsies with subsequent immune histological analysis for further investigation of the not very well researched Meigs syndrome is emphasized.
Schlüsselwörter
Meigs-Syndrom - Pleuraerguss - CA-125-Antigen - Pericarditis constrictiva - Thorakoskopie
Key words
Meigs syndrome - pleural effusion - CA-125-antigen - constrictive pericarditis - thoracoscopy - VATS
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Dr. André Lieber
Abteilung Chirurgie · Bundeswehrkrankenhaus Berlin
Scharnhorststraße 13
10115 Berlin
eMail: lieber.kamd.krs@t-online.de
