European Journal of Clinical Pharmacy

Background: Sertoli-Leydig cell tumors (SLCTs) are rare ovarian neoplasms originating from sex cord-stromal tissue and constitute less than 0.5% of all primary ovarian tumors.These tumors predominantly affect young women and may present with features of androgen excess; however, occurrence during pregnancy is uncommon.In the absence of endocrine manifestations, diagnosis during gestation is often incidental, creating diagnostic and management challenges.Case Presentation: A 29-year-old primigravida at 38 weeks of gestation with chronic hypertension and features of imminent eclampsia underwent emergency lower segment cesarean section and delivered a healthy 3 kg male neonate.Intraoperative assessment revealed a right-sided solid ovarian mass measuring approximately 10 × 6 cm.A right salpingo-oophorectomy was performed concurrently, while the left adnexa appeared normal.Histopathological examination demonstrated a well-encapsulated, moderately differentiated Sertoli-Leydig cell tumor composed of polygonal tumor cells arranged in illformed acini and diffuse sheets, with centrally placed nuclei and eosinophilic cytoplasm.Reinke crystals and heterologous elements were absent.Immunohistochemistry was not performed.The postoperative period was uneventful, and no adjuvant therapy was indicated.Sertoli-Leydig cell tumors presenting during pregnancy are extremely rare and may remain clinically silent until incidental intraoperative detection.Thorough inspection of the adnexa during cesarean delivery is essential for early identification.Fertility-sparing surgical management offers favorable outcomes in early-stage, moderately differentiated tumors.Careful long-term follow-up is recommended due to the potential risk of recurrence.