INTRODUCTIONIt is not rare to see patients with bilateral pleural effusion in clinical practice, and it is not unusual for such patients to present with exertional dyspnea [1]. Although several cardiopulmonary diseases account for most cases of pleural effusion [2], it occurs in diverse conditions and diseases. Bilateral pleural effusion develops in several systemic conditions such as hypoalbuminemia and collagen vascular diseases, and even in conditions unrelated to the cardiopulmonary system, including ovarian diseases such as Meigs' syndrome [3], a rare condition characterized by ovarian fibroma complicated by ascites and pleural effusion. We describe herein a patient presenting with exertional dyspnea who was diagnosed with pseudoMeigs' syndrome accompanying ovarian cancer. CASE REPORTA 61-year-old woman sought medical attention because of exertional dyspnea and an occasional wheeze that had developed one month previously without a noticeable triggering episode. She never smoked, consumed alcohol or took any medications. She underwent appendectomy at the age of nineteen, and was diagnosed when she was fifty as having myoma uteri, which was in stable condition on periodic check-ups. Her mother and a brother had diabetes, and another brother died of gastric cancer. Vital signs on presentation were as follows; blood pressure, 146/96 mmHg; pulse rate, 94 per minute with a regular rhythm; body temperature, 36.7°C; and respiration rate, 22 per minutes. She was neither anemic nor icteric. Finger clubbing was not noted. Neither lymphadenopathy nor venous dilation was noted on the neck. Thoracic examinations revealed diminished breath sound and dullness on percussion bilaterally. No wheeze was audible on this occasion. Heart sounds were not particular. Abdomen was flat, and there were no tender areas or masses on palpation. Neurological status was normal. Routine laboratory values were within the normal Kurume Medical Journal, 56, 85-87, 2009 Summary: A 61-year-old otherwise healthy woman presented with gradually worsening exertional dyspnea. Routine examinations revealed bilateral pleural effusion with no other notable cardiopulmonary diseases. Systemic examinations showed ascites and a pelvic tumor, which turned out to be right ovarian endometrioid adenocarcinoma. Surgical removal and chemotherapy against the ovarian cancer resulted in disappearance of the ascites and pleural effusion, establishing a diagnosis of pseudo-Meigs' syndrome. It is common for reported cases of pseudoMeigs' syndrome to initially present with dyspnea, therefore it is important to consider this disorder when attempting a differential diagnosis in female patients presenting with dyspnea without other noticeable conditions.