Background: Primary presacral tumour is extremely rare among adults. Such lesions are often found incidentally, because they may not show any clinical symptoms. Moreover, differentiation between cystic changes in ovary and presacral region is extremely difficult; it might even be a diagnostic challenge. Imaging studies should include transvaginal and transrectal ultrasound, computed tomography and magnetic resonance imaging, which are useful in identifying the exact location and suggest character of the tumour. Such diagnostics are helpful in determining the optimal surgical procedure.
Case Report: We present a case of a 26-year-old patient with abdominal pain. Imaging studies were performed; they revealed a presacral cyst 5 cm in diameter. Laparoscopic removal of the cyst was performed. Histopathological examination of the lesion confirmed a mature teratoma. The postoperative period was uneventful.
Conclusions: Due to the rarity of reported changes no firm guidelines exist. In the literature, depending on the anatomical conditions, descriptions of various surgical procedures are reported. The presented case confirms that surgical treatment can be performed by laparoscopy.

Keywords: sacrococcygeal teratoma, presacral teratoma, gynaecological laparoscopy