A 23-year-old woman presented with pelvic and right lower quadrant pain. Workup included abdominal MRI which revealed a bilobed pelvic mass in the pre-sacral space. The mass contained cystic and solid components. On physical exam, there was a small post-anal dimple. The arrow points to the more caudal of the two lobes.
An axial view shows the relationship of the mass to the coccyx. No pre-operative biopsy was attempted. The patient was taken to the operating room for resection with a differential diagnosis of tail-gut cyst, teratoma and dermoid.
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