Ovarian cystic teratomas are mainly composed of a cyst enterily or partly lined by epithelium resembling keratinized epidermis with sebaceous and sweat glands. The presence of floating balls or globules inside an ovarian cystic teratoma is an unusual finding. We report a 40-yearold with a history of pelvic pain for 6 months. The ultrasonographic evaluation showed an ovarian cyst of 26 x 16 centimeters with multiple mobile, spherical echogenic structures floating in the cystic mass. Right oophorosalpingectomy was performed by laparotomy. Histopathology diagnosis was mature cystic teratoma. The appearance of intracystic floating globules is rarely seen but it is pathognomonic for mature cystic teratoma.

Peritoneal tuberculosis is a common extrapulmonary site in females, mimicking an advanced ovarian malignancy. It is difficult to diagnose because it may produce massive ascites, and a gross peritoneal appearance similar to carcinomatosis. It requires confirmation by pathological studies and bacterial cultures, as there are not pathognomonic clinical, laboratory or radiologic findings. Early treatment usually is associated to good prognosis. A case of peritoneal tuberculosis with the classic triad (advanced-stage ovarian carcinoma-like ascites, abdominopelvic tumors and elevated serum CA-125 levels) is presented. Laparotomy showed abdominal and peritoneal nodules reported as granulomatous inflammation on biopsy. Patient started treatment and, on follow-up, symptoms and CA-125 levels normalized.