Mature cystic teratomas (MCTs) are rare tumors of embryonic origin composed of tissue from at least two of the germ layers. These tumors are common in females with a female-to-male ratio of 4:1. Most of the sacrococcygeal teratoma (SCT) in adults present as intrapelvic masses, in contrast to neonates, where >90% present as extra pelvic masses. These are extremely rare in the adult male pelvis; only nine cases have been reported in the literature, and they are usually asymptomatic. They may also present with urinary retention, pain, altered bowel habits, and rarely as prostatic abscess and chronic discharging sinus. Management is usually challenging because of difficult anatomical location and the risk of nerve and pelvic floor muscle injury leading to fecal and urinary incontinence. Here, we describe the clinical presentation, evaluation, and treatment of a case of MCT involving presacral space in an adult male with a review of the literature.
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