Summary

Cystic retrorectal tumours are a very rare entity that pose a problem in differential diagnosis between congenital cyst and other lesions. We present a 49-year-old female patient presenting a perineal bulge which was discovered simulating a vaginal birth associated with prolapsed haemorrhoids grade IV. The interest of this case resides in the surgical indication of a big presacral cyst demonstrated via CT causing acute intense pain due to pelvic organ compression, as no emergent surgery management has been reported up to date.