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 mechan- ism 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 pub-lished cases.' 1- Patients with atypical Meigs' syndrome may present a diagnostic problem as the clinical picture may masquerade as pulmonary tuberculosis or gynaecologi- cal carcinoma with metastatic involvement in the chest. They should, therefore, always be considered for explora- tory laparotomy.