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Abstract Ascites is defined as pathological fluid accumulation within the abdominal cavity (Senousy and Dragnov, 2009). It is one of the most frequent complications of cirrhosis and portal hypertension (Bendtsen et al., 2012),the development of ascites is associated with increased mortality. The mortality rates range between 15 and 20% in 1 year to nearly 50 to 60% in 5 years from the time of diagnosis(Planas et al., 2006)Malignant ascites is defined as an accumulation of excess fluid in the peritoneal cavity secondary to a disseminated malignancy (Becker et al., 2006). It isan ominous sign with an average survival of around 20 weeks from its diagnosis (Sangisetty and Miner, 2012). Ovarian malignancy is the most common cause, followed by pancreatobiliary and gastric malignancy and the primary tumor is unknown in 20% of cases (Barniet al., 2011).The diagnosis of malignant ascites can be difficult. The sensitivity of ascitic fluid cytology in peritoneal carcinomatosis is approximately 100%. However, because not all cases of malignant ascites are associated with peritoneal carcinomatosis, the overall sensitivity of cytology smears for the detection of malignant ascites is 58–75% Hepatocellular carcinoma (HCC) rarely metastasizes to the peritoneum (DiBonito et al, 1993). |