Atypical Meigs' syndrome.

Large blood-stained pleural effusions, especially in young patients, are unusual and may be caused by metastatic disease in the chest, a large pulmonary infarction, and, rarely, pulmonary tuberculosis. Meigs' syndrome is an uncommon cause of pleural effusion associated with ascites and a benign ovarian tumour, most often a fibroma. The fluid is usually clear but occasionally blood-stained. The mechanism of formation of the fluid remains a mystery ever since Meigs drew attention to this syndrome over 40 years ago. We report a case of atypical Meigs' syndrome, which is defined as the association of ascites and pleural effusion with uterine fibromata. We have found only four such published cases.' 1Patients with atypical Meigs' syndrome may present a diagnostic problem as the clinical picture may masquerade as pulmonary tuberculosis or gynaecological carcinoma with metastatic involvement in the chest. They should, therefore, always be considered for exploratory laparotomy.