This case of a malignant sacrococcygeal teratoma, usually a tumour of early childhood, presented as a bedsore in the lower end of the nuchal cleft of a 69-year-old man and proved to be malignant with a trophoblastic element. The literature of adult sacrococcygeal teratoma is reviewed; we have been able to find only three malignant examples.

A picture quiz and case report on an intensive care (ICU) patient with abdominal pain is reported in the present study. A computed tomography scan shows the typical signs of a poorly-understood disease, with a mortality rate of over 70 per cent. We outline the pathophysiology of this condition and recent advances in its diagnosis and treatment.