The patient was referred to our hospital for laparoscopic sleeve gastrectomy for her morbid obesity. At the time of surgery, a large right ovarian cystic mass lesion was discovered. The surgery was postponed after a diagnostic laparoscopy and the patient was referred to the gynecologist for further evaluation (tumor markers and abdominal CT scan).

CT scan showed a large benign looking multiseptated cystic right ovarian lesion, likely a mucinous cystadenoma.

Laboratory investigations: CA-125 = 21 U/ml (~35), CA 19.9 = <2 U/ml (~37), CEA = 4.5 ng/ml (~5).

Biopsies taken during the diagnostic laparoscopy were negative for any malignancy. After the complete work-up, the right ovarian lesion was excised and the histopathology revealed mucinous ovarian cystadenofibroma.