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Giant ovarian cysts are becoming less prevalent as a result of breakthroughs in imaging, routine gynecological surveillance, and early intervention in wealthy countries. However, in resource-constrained nations, delayed access to treatment, a lack of regular prenatal and gynecological follow-up, and socioeconomic constraints all contribute to late presentation and management difficulties.

We discuss the case of a 35-year-old Somali multiparous woman (G9P7) with a five-year history of increasing abdominal distension caused by a large mucinous cystadenoma. Abdominal ultrasound, contrast-enhanced CT scans, and tumor marker assessments all contributed to the diagnosis. She was assessed at our tertiary care center after a delay in seeking to a surgical care. A massive uniloculated cystic mass was found and entirely removed with unilateral salpingo-oophorectomy. A multidisciplinary team performed definitive surgical care, which was finished successfully without major complications, and the patient made a good postoperative recovery. Histopathological investigation confirmed the diagnosis of mucinous cystadenoma, with no signs of malignancy.

This case demonstrates the significance of earlier detection and interdisciplinary surgical care in achieving favorable outcomes for large ovarian tumors in resource-limited settings. The effective treatment of a long-standing huge mucinous cystadenoma in a young Somali woman demonstrates the importance of imaging, tumor markers, and coordinated surgical expertise in lowering morbidity and improving prognosis, Raising physician awareness and enhancing access to diagnostic and surgical procedures are critical to avoiding delayed presentations and related consequences.