A 27-year-old female underwent exploratory laparotomy after presenting with one-month history of continuous abdominal pain and distension, accompanied by fever, night sweat, and significant weight loss. She had a history of close contact with active TB patient, which completed ATD over 10 years before. This information ultimately raised a suspicion of TB. She underwent an adhesiolysis of sigmoid and fallopian tubes, also omental biopsy. The physical examination on subsequent presentation showed normal breath sounds, an abdominal scar from the laparotomy, without organomegaly (Fig. 3). Her chest x-ray showed minimal pleural effusion on right hemithorax, and abdominal ultrasonography revealed right ovarian mass with signs of malignant ascites. Whole abdominal CT-scan before her surgery confirmed a mass on right adnexal with signs of malignant ascites. She also had a high serum level of Ca-125 > 600 IU/mL (reference range from 0 to 35 IU/mL). Nonetheless, histopathology of omental biopsy confirmed a chronic granulomatous inflammation caused by TB without signs of malignancy (Fig. 4). She was then diagnosed with ITB and received 6 months of ATD.