A 36-year-old woman was seen with a large abdominal cystic mass in the left upper quadrant. During a cesarean section in 2001, the mass had been evaluated and drained; she was told that it was adherent to all adjacent structures and was nonresectable. Although the mass had been identified during her pregnancy 7 years before this presentation, her abdomen had recently become painful to touch while she was at work. Her medical and surgical histories are significant only for lupus erythematosus, hypertension, 2 cesarean sections, and a tubal ligation. She denied any food intolerance or recent trauma. She has a 30 pack-year smoking history and drinks 2 to 3 alcoholic beverages weekly. She has a remote history of spousal abuse.