所有儿童意外死亡事件都需要进行尸检以确定死因。在主动脉破裂的情况下，尸检可以轻易确定死亡的直接原因。尽管大多数主动脉破裂是由高强度创伤引起的，但不应忽略其他原因。我们介绍和讨论了一个29个月大的孩子在家中突然死亡的案例。她最近的病史和尸体外部检查观察到的瘀伤病变似乎可能嫌疑身体虐待。尸检结论是由于腹主动脉完全破裂并伴随着脊椎错位导致死亡。乍一看，整体的法医调查结果可能表明是一起外伤死亡事件。然而，对腹膜后区域的仔细检查揭示了瘀血肿内离散的非典型浸润性组织肿块。组织病理检查确认了软组织的肿瘤增殖，导致了血管和脊髓损伤。最终揭示了其他副肿瘤元素或转移（眼眶和皮下）。总的来说，这是一个罕见而致命的腹主动脉破裂肿瘤诱发的案例。由于引起脊椎错位和主动脉破裂的机制和力量，当意外创伤史不存在或与伤害不符时，两者的组合高度提示儿童虐待的可能性。然而，本案例说明了系统和严谨的法医检查的重要性，而不是忽略其他可能的诊断。 © 2023年该作者，在Springer-Verlag GmbH Germany独家许可下，作为Springer Nature的一部分。

All unexpected deaths of children require an autopsy to determine the cause of death. In cases of aortic rupture, the immediate cause of death is easily identified at autopsy. Although the majority of aortic ruptures are caused by high-energy trauma, other causes should not be missed.We present and discuss the case of a 29-month-old child who died suddenly at home. Her recent medical history and the ecchymotic lesions observed on external examination of the body appeared potentially suspicious of physical abuse. The autopsy concluded that death was due to complete rupture of the abdominal aorta with associated vertebral disjunction. At first glance, the overall forensic picture could suggest a traumatic death. However, careful inspection of the retroperitoneum revealed a discrete atypical mass of infiltrative tissue within the hematoma. Histopathological examinations confirmed tumor proliferation of the soft tissues, triggering vascular and spinal injuries. Other paraneoplastic elements or metastases were ultimately revealed (orbital and subcutaneous). Overall, this was a rare and fatal case of abdominal aortic rupture induced by tumors. Due to the mechanisms and the forces needed to cause vertebral dislocations and aortic rupture, the combination of the two is highly suggestive of child abuse when an accidental traumatic history is absent or inconsistent with the injuries. Nevertheless, this case illustrates the importance of a systematic and rigorous forensic examination, rather than ignoring other possible diagnoses.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.