Abstract
Ovarian cancer is the second most common gynecologic malignancy in the United States, with high mortality due to delayed diagnosis. Serum CA-125 is widely used for screening and monitoring but lacks sensitivity and specificity in some cases. We present a 67-year-old female diagnosed with advanced-stage ovarian cancer despite normal CA-125 levels, with elevated HE4 (human epididymis protein 4), underscoring its diagnostic value. This case highlights the importance of integrating HE4 with CA-125 in ovarian cancer evaluation and emphasizes a multimodal approach to enhance early detection and outcomes.