Malignant yolk sac tumor of the ovary presenting as adnexal torsion in a child: A rare case report with review of literature

Introduction: Malignant yolk sac tumor is a rare ovarian neoplasm with peak incidence in young women. Its occurrence in children less than 10 years old is extremely uncommon. In this manuscript we report a rare case of malignant yolk sac tumor presenting with adnexal torsion, emphasizing the role of multimodality imaging in management. Case Presentation: A 9-year-old female child was brought with the complaints of acute right lower quadrant pain, nausea and vomiting. On examination, the abdomen was tender with guarding. Laboratory investigations revealed leukocytosis, raised inflammatory markers and markedly elevated alpha-fetoprotein (AFP) levels. Ultrasonography revealed a mixed echogenic tumor in the right adnexa with features of adnexal torsion. Cross sectional imaging confirmed the presence of a heterogeneously enhancing tumor in the right adnexa with pelvic and paraaortic lymphadenopathy. Subsequently, the child underwent emergency laparotomy for adnexal detorsion with tumor excision. Postoperative histopathological examination confirmed malignant yolk sac tumor. Conclusions This case underscores the rare presentation of ovarian malignant yolk sac tumor as adnexal torsion in a child and the role of multimodality imaging in its management.