Adnexal mass with extremely high levels of CA-125 and CA19-9 but normal human epididymis protein 4 [HE4] and risk of ovarian malignancy algorithm [ROMA]: Endometriosis or ovarian malignancy?

Background: It has been shown that Carbohydrate antigen [CA] 125 and CA 19-9 tumor markers are useful for diagnosis and follow up of ovarian carcinoma

Case: In this case, we reported the high level of CA-125 and CA 19-9 with large right ovarian intact endometrioma and extensive involvement of omentum

Conclusion: Human Epididymis protein [HE4] and Risk of ovarian malignancy algorithm [ROMA] can be useful in differentiation between malignancies and benign pathologies with a good sensitivity and specificity value