The patient is a 59-year-old gravida 3, para 3-0-0-3 who underwent surgical menopause in 1973 after a vaginal hysterectomy performed for vaginal bleeding. She presents to her community physician with a complaint of abdominal distention. The physician confirms that there is a fluid wave in her abdomen.

Past medical history:
DM II
HTN
Asthma
Appendectomy
Tonsillectomy

1. What is your initial differential diagnosis?

The clinician proceeds to paracentesis. The results showed malignant cells, and a CT scan was obtained.

	CT scan 12-20

2. What do you see?

3. What labs would you want?