Germ cell tumors are the most common ovarian malignancies in female under the age of 21. However, they are very rare in older women. We present the eldest woman in the literature with an embryonal carcinoma. A 55-year-old woman complaining of irregular, heavy menses and pelvic pain was found to have a large pelvic mass and a positive pregnancy test. Subsequent investigation revealed a large right adnexal mass, and elevated β-HCG level. The pathological diagnosis of the mass identified at laparotomy turned out to be an embryonal carcinoma of the ovary. Although rare, the diagnosis of germ cell tumor should be considered in the differential diagnosis of an adnexeal mass in older women. Regardless of age, the treatment is similar; however, fertility-sparing treatment is not a priority in the older age group.

Keywords: Germ cell tumour, Embryonal carcinoma, Female genitalia, Malignancy, Advanced age