FDG PET/MRI Findings of Meigs Syndrome with Elevated CA-125

In this study, a 66-year-old female patient presented with chest tightness and shortness of breath due to recurrent massive pleural effusion. After the ultrasound-guided pleural puncture, pleural effusion cytology examination showed the presence of lymphocytes, neutrophils, and mesothelial cells; however, no atypia cells were found. Furthermore, the CA-125 tumor index was elevated (199.9 U/mL). Ultrasonography suspected ovarian malignant tumor combined with pleural and peritoneal effusion. To distinguish tumors from malignancy, the patient underwent PET/MRI scans, which showed low 18F-fluorodeoxyglucose (FDG) uptake. The high soft tissue resolution of the MRI provides basis for the localization and qualitative diagnosis of ovarian tumors. The tumor was solid cystic, and the hypointensity signal of the solid part on the T2-weighted image sequence indicated that the lesion may contain fibrous components, which may be fibroma or theca cell tumor. This was evidenced by the mild-to-moderate enhancement of mass after gadolinium enhancement. The final pathological diagnosis was fibroma of the ovary. After surgical resection of ovarian tumor, the disappearance of the pleural effusion and ascites conformed to the diagnosis of Meigs’ syndrome. In addition, multifunctional and multiparameter diffusion-weighted imaging sequence has a certain diagnostic value in the differentiation of benign and malignant ovarian tumors or ascites. The new PET/MRI technology combines the dual advant...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Oncology Source Type: research