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Ikhwan Rinaldi,1,2 Abdul Muthalib,1,2 Djaja Gosal,2 Teguh Wijayadi,2 Barlian Sutedja,3 Tjondro Setiawan,4 Andika Gunawan,5 Nelly Susanto,4 Lingga Magdalena,4 Diah Rini Handjari,6,7 Fetisari Kurniawan,6,7 Aisyah Rifani,8 Kevin Winston8 1Divison of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 2Department of Internal Medicine, Gading Pluit Hospital, Jakarta, Indonesia; 3Departement of General Surgery, Gading Pluit Hospital, Jakarta, Indonesia; 4Departement of Radiology, Gading Pluit Hospital, Jakarta, Indonesia; 5Departement of Nuclear Medicine, Gading Pluit Hospital, Jakarta, Indonesia; 6Department of Anatomical Pathology, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 7Departement of Pathology, Gading Pluit Hospital, Jakarta, Indonesia; 8Departement of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaCorrespondence: Ikhwan Rinaldi, Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Tel +62 811-177-997, Email ikhwanrinaldi@gmail.comIntroduction: Tuberculosis (TB) is a disease with high morbidity and mortality resulting from infection by Mycobacterium tuberculosis. TB can disseminate to any organ system of the body resulting in extrapulmonary tuberculosis. Interestingly, CA-125, which is a biomarker for some cancer, also rises in benign diseases such as pulmonary and extrapulmonary tuberculosis which may complicate diagnosis. In this case report, we present an abdominal tuberculosis patient that was initially presented as ovarian cancer.Case Report: A 30-year-old woman admitted to the emergency department with chief complaint of fatigue and shortness of breath since 3 months ago. She had lost around 20 kg weight in the past 5 months. She was previously suspected with ovarian cancer because of the characteristic features of malignancy, high levels of CA-125, and positive PET scan. She was later diagnosed with abdominal TB. Subsequently, the patient was given anti-TB drugs, and the patient showed clinical improvement.Conclusion: In the case of an elevated CA-125, clinicians should consider extrapulmonary TB as a differential diagnosis of ovarian cancer, especially in countries with high burden of tuberculosis.Keywords: extrapulmonary tuberculosis, CA-125, ovarian cancer, malignancy, case report