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Background: A case of vaginal endodermal sinus (yolk sac) tumor resulting in hydrometra in a 9-month-old female infant is reported., Case: The patient presented with an intermittent bloody discharge on her diapers and a lower abdominal mass on palpation. Multidetector-row computed tomography showed an irregular, dense soft-tissue mass with heterogeneous enhancement within the vagina, obstructing it. On reformatted computed tomography images, there was upstream dilatation of the cervical and uterine cavities, with fluid attenuation contents called hydrometra, resulting from the vaginal obstruction. The histopathological features of the vaginal mass were identical to those of the endodermal sinus tumor (yolk sac tumor). The patient was treated exclusively by means of chemotherapy., Conclusion: Examination of the alpha-fetoprotein levels was useful in the diagnosis of the patient and in assessing the patient's response to treatment by chemotherapy., (Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Endodermal sinus tumor is a malignant germ cell tumor which usually arises in gonads. Extragonadal endodermal sinus tumors in the head and neck are very rare. Here a gingival endodermal sinus tumor is reported. The lesion demonstrated typical microscopic features of the endodermal sinus tumors of gonads. The tumor cells showed alpha-fetoprotein immunoreactivity in immunohistochemical evaluation. The serum alpha-fetoprotein level was high. This is the first gingival case in the related literature.