Abstract
Sacrococcygeal teratomas are rare in adults, despite being common in infants. Adult presentations are often asymptomatic and may go undetected until complications arise. We report a case of a 20-year-old female with a long-standing sacral swelling. Imaging revealed a large, well-circumscribed mixed solid-cystic mass in the presacral region causing displacement of pelvic structures. Surgical excision of the tumor was done along with the surrounding rectal wall. Early surgical intervention is essential to prevent malignant transformation and optimize outcomes.