Gitto Lorenzo
Cook County Medical Examiner's Office, Chicago, Illinois, USA.
Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy.
J Forensic Sci. 2025 Sep 1. doi: 10.1111/1556-4029.70175.
Pseudo-Meigs syndrome is a rare clinical entity characterized by the triad of ascites, pleural effusion, and a benign pelvic tumor other than an ovarian fibroma. Although typically considered benign and reversible following tumor removal, the syndrome can result in severe life-threatening compromise if unrecognized or untreated. Unlike the classical Meigs syndrome, which has occasionally been associated with fatal outcomes, no deaths related to pseudo-Meigs syndrome due to benign tumors have been previously reported. This report presents the sudden death of a young adult woman who complained of acute shortness of breath and died shortly thereafter. Postmortem examination revealed more than 2.5 L of serous fluid within the thoracic and abdominal cavities, severe pulmonary collapse, and a markedly enlarged uterus containing a large leiomyoma. Histologic evaluation confirmed the tumor as a uterine leiomyoma. The findings observed at autopsy account for the proposed pathophysiologic mechanisms of death, in which impaired gas exchange and increased intrathoracic pressure likely compromised cardiac output, leading to death. These findings support a diagnosis of pseudo-Meigs syndrome with fatal cardiopulmonary consequences. This case represents the first fatality attributed to pseudo-Meigs syndrome associated with a benign tumor. Awareness of this potential outcome is essential for both clinicians and forensic pathologists when evaluating individuals with large benign pelvic tumors and unexplained cavity effusions.
假性梅格斯综合征是一种罕见的临床病症，其特征为腹水、胸腔积液以及除卵巢纤维瘤外的良性盆腔肿瘤三联征。尽管通常认为该综合征在肿瘤切除后是良性且可逆的，但如果未被识别或未得到治疗，可能会导致严重的危及生命的情况。与偶尔会导致致命后果的经典梅格斯综合征不同，此前尚无因良性肿瘤导致的假性梅格斯综合征相关死亡的报道。本报告介绍了一名年轻成年女性突然死亡的病例，该女性主诉急性呼吸急促，随后不久死亡。尸检发现胸腔和腹腔内有超过2.5升的浆液性液体、严重的肺萎陷以及一个明显增大的子宫，子宫内有一个大的平滑肌瘤。组织学评估证实该肿瘤为子宫平滑肌瘤。尸检观察结果解释了推测的死亡病理生理机制，即气体交换受损和胸内压升高可能损害心输出量，导致死亡。这些发现支持假性梅格斯综合征伴致命心肺后果的诊断。该病例是首例归因于与良性肿瘤相关的假性梅格斯综合征的死亡病例。当评估患有大型良性盆腔肿瘤和不明原因腔隙积液的个体时，临床医生和法医病理学家了解这一潜在结果至关重要。
