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The patient's cancer antigen 125 level dropped to 74.8 U/ml 1 month after surgery. Rarely, teratomas and mucinous cystadenomas may also give rise to an extremely high cancer antigen 125 level. The risk of malignancy index and risk of malignancy algorithm may both be misleading in these instances. Therefore, multidisciplinary input, fertility-sparing surgery, and follow-up are paramount to achieve optimal treatment and patient satisfaction. Rarely, teratomas and mucinous cystadenomas may also give rise to an extremely high cancer antigen 1
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