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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.<\/jats:p>","DOI":"10.1177\/23247096251344701","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T05:14:46Z","timestamp":1750223686000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["HE-4 in the Diagnosis of Carcinoma of Ovary Presented as Unknown primary Carcinoma: A Case Report"],"prefix":"10.1177","volume":"13","author":[{"given":"Shengmin","family":"Huang","sequence":"first","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Tahir","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gardith","family":"Joseph","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richrd","family":"Wu","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaron","family":"Tepper","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9623-6645","authenticated-orcid":false,"given":"Jen C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(59)90287-X"},{"issue":"1","key":"e_1_3_2_3_2","first-page":"1","article-title":"A case report of primary psammomatous serous adenocarcinoma of the Peritoneum","volume":"8","author":"Patil RP","year":"2016","unstructured":"Patil RP, Bharambe BM, Mahure AH, et al. 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