December 2016 A 38-year old female presented with bloating and pain PMH: unremarkable FH: no malignancy Abdominal/pelvic CT scan: pelvic mass (9-cm) arising from the right ovary, omental cake (15-cm), and extensive peritoneal carcinomatosis CA-125: 1027 U/mL The patient was diagnosed with stage IIIC epithelial ovarian cancer She underwent hysterectomy, bilateral salpingo-oophorectomy, and omentectomy Scattered residual peritoneal nodules (<1 cm) remained following surgery Following surgery, treated with 6 cycles of IP/IV carboplatin/paclitaxel After 6 cycles of therapy, CA-125 level declined to 2.5 U/mL Symptoms were ameliorated March 2017 Patient reported bloating and abdominal pain Lab results showed elevated CA 125 (985 U/mL) CT scan confirmed recurrence with ascites and visible disease (2-cm peritoneal mass) She was treated with bevacizumab and topotecan for 4 cycles Patient had good response therapy After 4 cycles, she was switched to bevacizumab maintenance October 2017 Patient returned with complaint of abdominal pain CT scan revealed ascites and several 1- to 2-cm peritoneal masses in the pelvis and upper abdomen