<h4>Background</h4>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.<h4>Case</h4>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.<h4>Conclusion</h4>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. Here, WFDC2 is linked to ovarian carcinoma.