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Pseudo- Meigs' syndrome caused by uterine smooth muscle tumor of uncertain malignant potential with low vascular endothelial growth factor expression
  1. S. E. Huang*,
  2. S. C. Huang*,
  3. W. Y. Lee and
  4. K.-F. Hsu,§
  1. *Department of Obstetrics and Gynecology, Chi Mei Medical Center, Liou Ying Campus,
  2. Department of Pathology, Chi Mei Medical Center,
  3. Department of Obstetrics and Gynecology,
  4. §Institute of Clinical Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
  1. Address correspondence and reprint requests to: Keng-Fu Hsu, MD, Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan. Email: d5580{at}mail.ncku.edu.tw

Abstract

Smooth muscle tumor of uncertain malignant potential (STUMP) presenting as pseudo-Meigs' syndrome with low vascular endothelial growth factor (VEGF) expression has not been reported in previous literature. Here, we report a case of uterine STUMP associated with ascites and pleural effusion, which was resolved completely after hysterectomy. A 47-year-old woman presented to the clinic with a complaint of progressive abdominal distension for several months. A large movable, painless pelvic mass located upward above the umbilical level was palpated. Sonography and computed tomography showed a hypervascular solid pelvic mass measuring 20 × 17 × 15 cm in size associated with ascites and right pleural effusion. Laparotomy revealed a large uterine mass with ascites in the abdomen. Total hysterectomy and left-side salpingo-oophorectomy were performed. The final pathologic report revealed a STUMP tumor with low expression of VEGF by immunohistochemistry. A follow-up chest X-ray revealed that the pleural effusion was resolved completely 1 week postoperatively. The patient is doing well without recurrence in the following 2 years. Uterine STUMP tumor may cause pseudo-Meigs' syndrome. However, the ascites or the pleural effusion may not be induced by VEGF, known as vascular permeability factor, in our case.

  • pseudo-Meigs' syndrome
  • smooth muscle tumor of uncertain malignant potential
  • vascular endothelial growth factor

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