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Unusual presentation of invasive hydatidiform mole metastasizing to the lung

also reported. Transvaginal ultrasound showed only a 42637 mm simple cyst in the left ovary without vascularisation. The serum CA125 level was very high (2,168 UI/ml). An exploratory laparotomy with frozen section examination was carried out on the assumption that ovarian cancer was the most likely diagnosis. Some 8 litres of ascitic fluid were drained and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Final pathological examination showed a sclerosing stromal tumour of the right ovary and a serous cystadenoma of the left ovary. No malignant cells were found in the ascitic fluid. A biopsy of the hepatic lesions showed haemangiomas. After surgery, ascites did not recur, pleural effusion disappeared and the CA125 level returned to normal. Sclerosing stromal tumour is a rare benign ovarian tumour originating from granulosa stromal cells. It occurs most frequently in the second and third decades of life and the most common presenting symptom is menstrual irregularity. Ascites may occur but is rare and usually of small volume. Meigs’ syndrome is defined as the triad of benign ovarian tumour with ascites and pleural effusion that resolves after resection of the tumour, although when the histology is other than fibroma, it is sometimes referred to as pseudo-Meigs’ syndrome. So far, sclerosing stromal tumour in association with Meigs’ syndrome has been reported in two cases (Bildirici et al. 2004; Jung et al. 2006), and CA125 elevation was found in three sclerosing stromal tumour cases (Huang et al. 2003; Jung et al. 2006; Terauchi et al. 2005). However, to our knowledge, in only one situation it presented with both Meigs’ syndrome and elevated CA125 (Jung et al. 2006), the present case being the second one to be reported. In 2003, Huang et al. reported a sclerosing stromal tumour case in which there was ascites and CA125 elevation, but no pleural effusion was described. A clinical picture highly suggestive of ovarian malignancy turned out to be a benign condition. We believe sclerosing stromal tumour was responsible for this clinical presentation as there are no reports of Meigs’ syndrome associated with serous cystadenoma. The patient’s age in this case was also atypical, favouring the diagnosis of malignancy.