Struma Ovarii Associated with Pseudo - Meigs ’ Syndrome

Struma ovarii is a specialized ovarian teratoma composed predominantly of mature thyroid tissue. It is associated with pleural effusion and ascites (Pseudo-Meigs’ syndrome) in 5% of cases. Majorities of the strumas are benign, however occasionally malignant transformation may be seen. We report a case of a 45 years old postmenopausal woman who presented with gradually increasing dyspnoea and distention of abdomen of five months duration. USG abdomen revealed a bulky right ovary with a solid and cystic components and ascites. Her chest X-ray showed bilateral pleural effusion. Hence, clinical diagnosis of malignant ovarian tumor was kept; however, both the ascetic & pleural fluids were cytologically negative for malignant cells. The patient was operated forhysterectomy with bilateral salpingo-ophorectomy. The histopathological examination of the ovarian mass confirmed the diagnosis of struma ovarii. Postsurgical follow up of patient showed spontaneous regression of pleural effusion and ascites. The coexistence of an ovarian tumor, ascites and bilateral pleural effusion that resolves spontaneously on resection of the ovarian mass is known as pseudo-Meigs’ syndrome. Patient with pseudoMeigs’ syndrome may present a diagnostic problem as they masquerade as carcinoma with malignant effusions. In addition, the coexistence of struma ovarii and pseudo-Meigs’ syndrome is a very rare event.