Case presentation A 36-year-old woman is brought to the hospital with a complaint of abdominal swelling for ten months. The patient has been married for seven years and trying to conceive. But she has not been able to conceive. She has not taken any contraceptives ever. She reported no sign of abdominal pain but just the swelling.

Also, she has a normal bowel movement with frequent urination without dysuria. The patient further complained of nauseatic feeling after consuming a heavy meal. Medical history The patient has a history of regular, heavy, clotty menstrual bleeding on the second and third day of the cycle and hasn’t received any treatment for that. Examination Upon bimanual examination, a non-tender firm mass was observed around the pelvis. Laboratory investigations Complete blood count - Hb: 6.3 g/dL Mean cell volume - 68 fL Magnetic resonance imaging (MRI) of the abdomen and…