Case 403 Medical history 32-year-old female patient with complaints of postprandial fullness, abdominal cramps and bulging of the abdomen that started 6 months ago. On physical examination, a palpable mass was observed in the left hypochondrium and flank. Fluid wave test was negative. Denies weight loss. Ultrasound (US) and computed tomography (CT) of the abdomen, colonoscopy and laparoscopy were requested, and the biopsy specimens revealed features of desmoplastic small round cell tumor. Tomografia computadorizada (TC) de abdome e pelve, reconstrução coronal, após injeção intravenosa do meio de contraste iodado, fase portal.TC de abdome e pelve, reconstrução coronal, após injeção intravenosa do meio de contraste iodado, fase portal. TC de abdome e pelve, cortes axiais, ao nível dos hipocôndrios (A), do ceco (B) e do túber isquiático (C), após injeção intravenosa do meio de contraste iodado, fase portal.Laparoscopy of the peritoneal cavity in the topography of the greater omentum (A and B), the pelvis (C) and the pouch of Douglas (D). Question:Considering the clinical history, the imaging exams and the diagnosis indicated by the biopsy, which of the alternatives below describes the most appropriate medical approach? Surgery Chemotherapy Radiation therapy Chemotherapy and surgery Time is Up! Time's up