Exploratory laparotomy revealed a large retroperitoneal mass of size 32x15x15cms with solid and cystic components. Tumor was located posterior to descending colon and mesocolon. Stomach and pancreas were pushed upwards and anteriorly where as left kidney was grossly ABSTRACT Of all primary retroperitoneal teratomas, less than four percent occur in children and 90% are benign. Here we report a case of malignant retroperitoneal teratoma (dermoid) in a 15 year old girl who presented to our hospital-Acharya Vinoba Bhave Rural Hospital (AVBRH). She presented with a tender, large, irregular mass with variegated consistency in the entire left side of abdomen crossing midline. Ultrasound of abdomen suggested a complex intraabdominal mass with septations and lobulations. It was not feasible to use other imaging modalities for evaluation due to poor socioeconomic status and illiteracy. Patient underwent exploratory laparotomy with tumor resection along with left kidney and part of the descending colon which was densely adhered to tumor. Histopathological examination of tumor was suggestive of immature teratoma. Post operative recovery was uneventful and patient was discharged from the institution. Tissue adherence which can be observed in both benign and malignant form of teratomas, requires extended surgery for removal of adhered organ for the completeness of surgery and good prognosis.