Ruptured ovarian yolk sac tumor combined with hemoperitoneum in a young girl with abdominal blunt injury

We report our clinical experience concerning the incidental finding of a ruptured ovarian yolk sac tumor combined with hemoperitoneum in a patient with abdominal blunt injury. An girl 8 years of age visited emergency department due to vomiting and persistent abdominal pain after abdominal blunt injury. Physical examination revealed pale conjunctiva, abdominal distension, and tenderness over bilateral lower abdomen without any obvious peritoneal sign. After stabilization of her condition, one huge pelvic tumor with ascites was identified by abdominal sonography and computed tomography scan. Subsequently, hemoperitoneum was confirmed by paracentesis procedure. During exploratory laparotomy, one ruptured left ovarian tumor with bleeding was identified. Therefore, she underwent left oophorectomy and left salpingectomy. Typical structures of Schiller-Duval bodies and hyaline globules in the tumor cells were identified. Biopsy of the omental tissues also confirmed metastatic lesions of the tumor. Ovarian yolk sac tumor (FIGO Stage 3) was confirmed. She received four courses of chemotherapy after the operation and received subsequent regular follow-up at the hospital with an uneventful recovery. This case highlights the possibility of ruptured ovarian yolk sac tumor after abdominal blunt injury as the cause of internal bleeding, and it should be taken into consideration as one possible etiology of hemoperitoneum in a young girl.