Background: High level of CA 125 with associated ovarian mass is highly suspicious of ovarian carcinoma but the possibility of other benign conditions with associated pelvic mass and elevated CA 125 also to be considered. Case Report: We present a case of 51 year old female, who presented with menorrhagia and a pelvic mass with a raised CA 125 of 983.1 U/ml. With a clinical diagnosis of ovarian carcinoma, she underwent staging laparotomy and post operative specimen was subjected for histopathological examination. The biopsy showed benign cystic teratoma with endometriosis in the opposite ovary. Conclusion: The present case emphasizes that not all pelvic masses with raised CA 125 should prompt the diagnosis of ovarian carcinoma, there are various other benign conditions which should be included in the differential diagnosis of a perimenopausal woman. Good clinical history and screening for other benign conditions should be given importance in such patients.

Keywords: Elevated CA 125; Benign Cystic Teratoma; Endometriosis