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The emergency room was visited by a 29-year-old female patient who had a history of back pain and amenorrhea (x several years). The CT scan revealed a 7.8 cm complicated right ovarian mass with calcifications, and a serological analysis revealed high levels of AFP and testosterone. Peritoneal staging biopsies, a partial omentectomy, and a right salpingooophorectomy were all carried out. Histological analysis of the right ovary revealed mature tissue components such skin, skin appendages, and adipose tissue in the cystic portions and spindled cells with Schwannian characteristics in the solid areas (both positive for synaptophysin and chromogranin A). FISH tests revealed no N-MYC amplification. a Ganglioneuroblastoma diagnosis developing within a mature cystic They created teratoma. We outline the differential diagnostic considerations for this entity and present the second example of it appearing in an ovarian teratoma that has been documented in English literature. Owing to its rarity, this tumour could be difficult for pathologists to diagnose and difficult for gynaecological oncologists to treat. A 29-year-old nulligravida female who had been experiencing increased back pain for a year and had been taking over-the-counter medicine presented to the emergency room. There was no prior history of any associated diarrhoea, constipation, diarrhoea, fever, or early satiety.