Background: Spontaneous postpartum rupture of a Sertoli-Leydig cell ovarian tumor is an infrequent complication of a rare tumor.
Case: A 21-year-old nullipara with an uneventful prenatal course and spontaneous vaginal delivery experienced severe intraabdominal bleeding with hypovolemic shock postpartum from the rupture of a previously undiagnosed Sertoli-Leydig cell ovarian tumor. Diagnosis and intervention were delayed because of the late development of overt signs of intraabdominal bleeding and misleading findings on abdominal examination. Vigorous uterine compression may have precipitated the bleeding. Emergency exploration and surgical intervention were successfully undertaken. Full staging of the cancer was not possible at the initial surgery because of the patient's cardiovascular instability.
Conclusion: Rupture of a Sertoli-Leydig cell tumor is a potential cause of postpartum hypovolemic shock resulting from massive intraabdominal bleeding.