Malignant Yolk Sac Tumor of the Ovary Presenting as Adnexal Torsion in a Child

A rare case report with review of literature

Authors

  • Kabhilan A K Consultant, Department of Radiodiagnosis, Hannah Joseph Hospital, Madurai- 625009, Tamil Nadu, India
  • Ebinesh Arulnathan Pediatric Radiology Fellow, Department of Radiology, Alder Hey Children’s NHS Foundation Trust, Liverpool- L14 5AB, UK. https://orcid.org/0000-0001-8778-9902 (unauthenticated)
  • Karunakaran N Senior Consultant and Chief Radiologist, Department of Radiodiagnosis, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India.
  • Padma S Senior Consultant and Head, Department of Gynecology, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India
  • Praislin Gideon Junior Clinical Fellow, Department of Emergency Medicine, Royal Free NHS Foundation Trust, London- NW3 2QG, UK.

DOI:

https://doi.org/10.59667/sjoranm.v23i1.18

Keywords:

Malignant Yolk Sac Tumor, Ovarian Germ Cell Tumor, Adnexal Torsion, Pediatric Ovarian Tumors, Multimodality Imaging

Abstract

Introduction: Ovarian yolk sac tumor is a rare malignant germ cell neoplasm. We report its presentation with adnexal torsion in a nine-year-old child, highlighting the role of imaging in assessment and management.

Case Presentation: A nine-year-old girl presented with acute right lower quadrant pain, nausea and vomiting. Examination revealed abdominal tenderness and guarding. Laboratory investigations showed leukocytosis, raised inflammatory markers and markedly elevated alpha-fetoprotein. Ultrasound demonstrated a heterogeneous right adnexal mass with absent Doppler vascularity, raising suspicion of torsion. CT and MRI characterized the mass and associated pelvic and para-aortic lymphadenopathy. Emergency laparotomy revealed twisted vascular pedicles. Right salpingo-oophorectomy and lymph node dissection were performed. Histopathology confirmed yolk sac tumor with nodal involvement. The postoperative course was favorable, with complete recovery within two weeks.

Conclusions: This case illustrates the rare presentation of ovarian yolk sac tumor with adnexal torsion in a child. Imaging supports assessment of the mass and its complications; suspected torsion requires timely surgical assessment.

Author Biographies

  • Kabhilan A K, Consultant, Department of Radiodiagnosis, Hannah Joseph Hospital, Madurai- 625009, Tamil Nadu, India

    Dr Kabhilan A K, MBBS, DNB. Consultant, Department of Radiodiagnosis, Hannah Joseph Hospital, Madurai- 625009, Tamil Nadu, India. Email: kabhilan06@gmail.com 

  • Ebinesh Arulnathan, Pediatric Radiology Fellow, Department of Radiology, Alder Hey Children’s NHS Foundation Trust, Liverpool- L14 5AB, UK.

    Dr Ebinesh Arulnathan, MBBS, MD, MICR, DNB, FRCR, EDiR, DICRI (Corresponding author),  Prof Carty Pediatric Radiology Fellow, Department of Radiology, Alder Hey Children’s NHS Foundation Trust, Liverpool- L14 5AB, UK. Email: ebinesh.arulnathan@alderhey.nhs.uk 

  • Karunakaran N, Senior Consultant and Chief Radiologist, Department of Radiodiagnosis, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India.

    Dr Karunakaran N, MBBS, DMRD, DNB. Senior Consultant and Chief Radiologist, Department of Radiodiagnosis, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India.  Email: mathivathani07@gmail.com

  • Padma S, Senior Consultant and Head, Department of Gynecology, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India

    Dr Padma S, MBBS, MD, DNB. Senior Consultant and Head, Department of Gynecology, Meenakshi Mission Hospital and Research Centre, Madurai- 625107, Tamil Nadu, India. Email: communications.academics@gmail.com

  • Praislin Gideon, Junior Clinical Fellow, Department of Emergency Medicine, Royal Free NHS Foundation Trust, London- NW3 2QG, UK.

    Dr Praislin Gideon, Junior Clinical Fellow, Department of Emergency Medicine, Royal Free NHS Foundation Trust, London- NW3 2QG, UK. Email: praislin.gideon@nhs.net

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SJORANM article cover, Vol. 23 No. 1 (2025). Holographic symbolic illustration for article 82.

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Published

2025-09-26

Data Availability Statement

The clinical findings and relevant imaging are described in this case report. No separate research dataset was generated.

Issue

Vol. 23 No. 1 (2025)

Section

Case reports

License

Copyright (c) 2025 Kabhilan A K, Ebinesh Arulnathan, Karunakaran N, Padma S, Praislin Gideon

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

This license requires that reusers give credit to the creator. It allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, even for commercial purposes.

How to Cite

A K, K. ., Arulnathan, E., N, K., S, P., & Gideon, P. (2025). Malignant Yolk Sac Tumor of the Ovary Presenting as Adnexal Torsion in a Child: A rare case report with review of literature. Swiss Journal of Radiology and Nuclear Medicine, 23(1), 5-13. https://doi.org/10.59667/sjoranm.v23i1.18

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