Malignant extragonadal germ cell tumors, though more common in infants and children, are rare. They occur in the body's midline and may have internal and external manifestations. We report a case of an 11-month-old female with sacrococcygeal extragonadal yolk sac tumor manifesting as a draining subcutaneous nodule after initial treatment as an abscess. Extragonadal germ cell tumors can present with external manifestations confusingly similar to other more benign soft tissue conditions.