Background: Teratomas are a type of germ cell tumor, which are mostly benign, and dominative in adult females. Sacococcygeal teratomas are usually found in newborns or children, and can be detected prenatally;they are exceedingly rare in adults. We reported a case of a sacrococcygeal teratoma in adult female. Case presentation: A 26-year-old female was diagnosed with a presacral tumor 6 years ago. Pelvic computed tomography (CT) demonstrated a presacral heterogeneous tumor, containing multi-located cystic area and enhanced solid component with calcification. Magnetic resonance imaging (MRI) showed a presacral non-enhanced cystic lesion with solid component, 128 mm × 104 mm × 102 mm, which was suspected of having invaded the rectal wall, fifth sacral vertebra (S5), and coccyx. She underwent abdomino-sacral total excision of tumor with coccygectomy. Histopathological examination revealed a tumor with intricate admixture of ectodermal (epidermis, sebaceous glands and squamous), mesenchymal (cartilage, adipose tissue, blood vessels, nerves and skeletal muscle) and endodermal components (respiratory epithelium and intestinal epithelium) respectively. After 24 months of follow-up the patient was both clinically and radiologically disease free. Conclusions: Early complete excision was the preferred definitive modality of treatment for sacrococcygeal teratoma, and multi-staged excision and reconstruction resulted in successful and safe treatment in our case.
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