A 16-year-old female was admitted to the hospital with a 7-day history of tenderness in the abdomen who was referred from another centre to us with reported ascites in ultrasonography. No chronic diseases, no alcohol use, no family history, no herbal agents, or no suspected drug use were reported. Vital signs of the patients were in the normal ranges with 36.3 body temperature, 120/70 arterial blood pressure, and 82/min heart rate. Our physical examination referred ascites in the abdominal region, and there was no other abnormal finding. Our laboratory results reported no anemia, no white blood cell elevation, and no thrombocyte abnormality. Her peripheral smear was normal with no atypical cells. No renal function or hepatic function abnormality and no electrolyte abnormality were also reported. CRP was 39 (normal range: 0-5 mg/L) and erythrocyte sedimentation level was 42 (normal range: 0-20 mm/h). Her chest X-ray was completely normal with no infiltrations or effusions. Her abdominal ultrasonography reported abdominal free liquid deposition, septations in the fluid accumulation, and multiple implants in peritoneal surfaces in hepatic diaphragmatic region and right paracolic area, in which the biggest one was 16 millimetres. Endometrium thickness was in the normal range, but in the left ovary, there was a septated cyst with dimensions of 39*27 millimetres (hemorrhagic cyst?). We suspected from ovarian pathology and performed paracentesis and sent this fluid to pathology laboratory. Pathology reported inflammatory cells which are rich in lymphocytes. There were no malignant cells in the fluid. According to the laboratory results, serum albumin ascites gradient was <1.1, and this showed us that the fluid was exudate. The patient's thyroid function tests were completely normal. Laboratory investigations showed the following values: AFP level 2.48 (normal range: 0-7 ng/mL), CEA level 0.39 (normal range: 0-3.8 ng/mL), CA15-3 level 26.15 (normal range: 0-26.4 U/mL), CA19-9 level 1.14 (normal range: 0-27 U/mL), and elevated CA125 level of 107.5 (normal range: 0-35 U/mL). Brucella markers and viral markers were negative. Although the patient had no encounter with any tuberculosis patient, we performed tuberculin skin test for differential diagnosis. As a result, it was anergic. Tuberculosis quantiferon PCR was negative, and ascites fluid direct microscopic examination revealed that there were no tuberculosis bacilli and acid-fast stain was negative. Tomography of the thoracoabdominal region revealed nasopharyngeal soft tissue with the dimensions of 20*18 millimetres, bilateral lymphadenopathies in the levels of 1a, 1b, 2, 3, 4, and 5, and right supraclavicular area in the cervical region. The nasopharyngeal biopsy revealed just lymphoid hyperplasia. Paratracheal and subcarinal lymphadenopathies were also seen, and the biggest one was 20*13 millimetres. Also, there were bilateral anterior diaphragmatic and right cardiophrenic lymphadenopathies. Abdomen tomography showed fluid accumulation and hepatic peritoneal surface nodular lesions. There were a reticular density increase in the omental area and a cyst in the left ovary with the dimensions of 23*18 millimetres. There were also lymph nodes in the mesenteric fatty tissue. Although malignancy was important for differential diagnosis, ADA (adenosine deaminase) level was 62 (normal range: 0-30 U/L). These results strongly supported tuberculosis. Then, we sent peritoneal fluid to the pathology laboratory again and no malignant cells were reported. Abdomen magnetic resonance imaging reported bilateral cysts in both the ovarian regions, bilateral expanded fallopian tubes, nodular opacities in the peritoneal region, and ascites (Figure 1). We performed trucut biopsy from nodular opacities in that peritoneal surface, and pathology laboratory reported granulomas with histiocytic cells in that specimen. We communicated with infectious diseases committee and started four-agent tuberculosis treatment (isoniazid, ethambutol, pyrazinamide, and rifampin) to the patient. After 6 months of treatment, she had good clinical response and ascites were completely absent.