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Ovarian Sertoli cell tumors (SCTs) are a rare subgroup of gonadal ovarian neoplasms. They typically occur in young patients and are usually benign. We present a case report of an elderly patient with uterine maldevelopment in whom a gigantic ovarian SCT was diagnosed.

A 62-year-old woman presented to the emergency department for treatment of a lower limb infection. She additionally reported abdominal girth, loss of appetite, and a sensation of epigastric fullness. Physical examination revealed an abdominal mass. Imaging showed a massive tumor measuring approximately 19.0×12.0×19.0 cm. Initial differential diagnosis included uterine fibroid or ovarian teratoma. Laparotomy was performed, during which a normal uterus was not identified. The excised tumor had a smooth capsule, a solid lobulated structure, and a grayish-yellow color with fine calcifications. Peritoneal fluid obtained at surgery contained no malignant cells. Follow-up at 16 months showed no clinical or radiological evidence of recurrence. The patient's follow-up is ongoing.

This case underscores the importance of including rare ovarian tumors in the differential diagnosis of pelvic masses, particularly in patients with congenital reproductive tract anomalies.