Computed tomography of the stomach and pelvis exposed ascites, a mass in the proper upper quadrant, and omental caking. The outcomes of esophagogastroduodenoscopy and colonoscopy were unremarkable. The patient underwent paracentesis then. In June 2007, he underwent exploratory laparotomy, which showed massive omental caking with discrete, round, gelatinous, grape-size tumor nodules and intensive peritoneal disease. Maximal tumor debulking was performed along with catheter placement to facilitate administration of a hyperthermic peritoneal perfusion of cisplatin, doxorubicin, and mitomycin C. The tumor was made up of epithelioid cells with large vesicular nuclei predominantly, prominent nucleoli, and amphophilic cytoplasm, embedded in a myxoid stroma with prominent neutrophils .Acceleron Pharma, a biotechnology business in Cambridge, Massachusetts , designed ACE-041 to inhibit ALK-1 signalling and asked Prof Sharma to end up being among the investigators to conduct the first-in-man stage I clinical trial of the drug to see if it would inhibit tumour angiogenesis. Since ALK-1 is transiently expressed on proliferating endothelial cells , in contrast to the VEGF receptors which are expressed on endothelial and other cells constitutively, it may be a far more selective focus on for the inhibition of angiogenesis, stated Prof Sharma.