Ruptured clear cell carcinoma of the ovary presenting as acute abdomen

•This is the first report of spontaneous rupture of clear cell ovarian carcinoma.•Ruptured tumors should remain in the differential diagnosis of acute abdomen.•Stage 1 due to rupture has a better prognosis than ascites and surface involvement.

BackgroundOvarian cancer remains one of the leading causes of cancer-related deaths among women. Clear cell ovarian carcinoma is a rare histologic subtype accounting for 5–10% of all epithelial ovarian cancers and is often associated with endometriosis. Patients generally present with vague abdominal and pelvic complaints. However, patients can present in the acute setting with pleural effusions, ascites, bowel obstructions, and deep vein thrombosis.CaseA 54 year old woman presenting with an acute abdomen secondary to rupture of ovarian clear cell carcinoma.ConclusionOvarian clear cell carcinoma should remain in the differential diagnosis in a patient presenting with an acute abdomen and imaging suspicious for a gynecologic malignancy originating from the ovary.