"Pseudo-ascites" associated with giant ovarian cysts and elevated cystic fluid amylase

Two patients with massive ovarian cysts that mimicked ascites on physical examination, ultrasonography, and abdominal plain film are reported. Elevated cyst amylase in both patients, and in one, elevated serum amylase, further confused the diagnosis. Massive ovarian cysts should be considered in the differential diagnosis of presumed ascites in female patients, particularly in the setting of elevated serum or "ascitic" fluid amylase.