Tubo-Ovarian Abscess with Highly Elevated CA125 Level is Misdiagnosed as Ovarian Cancer: A Case Report

Complex pelvic masses with elevated CA125 could be due to malignant and benign condition. Tubo-ovarian abscess, with irritation of the peritoneum, could increase the level of CA125 and mimic advanced ovarian cancer. Preoperatively, high accuracy radiological evaluation can reduce the high risk and unnecessary laparotomies. The patient was a 50-year-old near menopause woman with abdominal pain, fever and recent vaginal bleeding with highly elevated CA125 (>4000 u/ml) and complex pelvic mass, suspected of ovarian cancer with final pathology of tubo- ovarian abscess (TOA). Misdiagnosed TOA with ovarian cancer only based on highly elevated CA₁25 and performing upfront radical surgery in stable patients could result in visceral injury.