Hemothorax resulting from hemorrhagic degeneration of giant uterine leiomyomata: A rare variant of pseudo-Meigs’ syndrome

Though rare, hemothorax can occur without trauma, coagulopathy, or apparent vascular injury. Similar to the proposed mechanism of Meigs' syndrome or hepatic hydrothorax, small diaphragmatic defects may allow peritoneal fluid to traverse the diaphragm into the pleural space. While typically this is associated with transudative pleural effusions, there have been case reports of hemoperitoneum crossing the diaphragm into the pleural space. Here, we present a case in which multiple giant leiomyomata with hemorrhagic necrosis led to hemoperitoneum that translocated across the diaphragm into the pleural space, causing a hemothorax.