Abstract
Myelolipomas are rare benign tumors that are commonly found in the adrenal glands. Extra-adrenal locations are rare, and presacral myelolipomas represent the most common extra-adrenal location. The differential diagnosis of malignant presacral neoplasms is very challenging. We present a case of a presacral neoplasm that was completely removed with a laparoscopic approach and diagnosed as a myelolipoma only after pathological examination.