Meigs-like syndrome presenting as cardiac tamponade

A 55-year-old woman with a history of hypertension was admitted to our institution due to severe dyspnea. On physical examination tachypnea, hypotension, and bilateral jugular distension were detected. The electrocardiogram showed sinus tachycardia. Chest radiography revealed mild bilateral pleural effusions and severe cardiomegaly (Figure 1A). An echocardiogram showed a 3-cm global pericardial effusion with signs of cardiac tamponade (Figure 1B). Due to the patient’s clinical instability, drainage of the pericardial effusion was mandatory, but pericardiocentesis was unsuccessful due to catheter obstruction, and so surgical drainage was performed through a pleuropericardial window. Cytology and pericardial biopsy detected no malignant cells. Abdominal computed tomography showed ascites and a 3 cm × 4 cm ovarian fibroma (Figure 1C). Given the benign nature of the tumor, an expectant attitude was adopted.