Epithelial ovarian cancer constitutes approximately 85% of all ovarian malignancies. The lack of overt symptoms and good screening strategies precludes early diagnosis and thus greater than 70% of patients present with extensive local disease and peritoneal spread (1). While the five-year survival for patients presenting with advanced disease has improved over the past decade, there has been no increase in the number or frequency of cures of advanced ovarian cancer. The symptoms of both early and late stage ovarian cancers are frequently nonspecific, including abdominal complaints, bloating, and altered bowel habits, in part due to local tumor growth confined in stages I and II to the ovaries or pelvic organs prior to serosal spread in the abdomen. With advanced stage, the peritoneum, diaphragm, and omentum are seeded with micro- and macro-metastases of tumor cells, resulting in solid tumor masses and ascites that cause further bloating, cramping, pain and bowel complaints. Unlike its solid tumor counterparts that invade blood vessels and lymphatics and metastasize early, epithelial ovarian cancer spreads initially by surface shedding. This is followed by invasive peritoneal implantation, growth and further invasion. Distant parenchymal metastases are less common at presentation but may be seen with progression of epithelial ovarian cancer. The growth of ovarian tumors is associated frequently with the development of ascites, which is rich in cytokines and growth factors.