Presacral epidermoid cyst in an elderly female, mistaken for ovarian cystadenoma.

Epidermoid cyst is of common occurrence in other parts of the body, but has rarely been described in the presacral space [1]. It is a benign congenital lesion, mostly seen in middle-aged females and is usually asymptomatic. Pathologically, it contains a thin wall lined by stratified squamous epithelium with a mixture of desquamated debris, keratin, cholesterol, and water. From the development aspect, it arises from the sequestration of the ectoderm following the closure of the neurenteric canal, proctodeal membrane, or post-anal gut [2]. The major complications of epidermoid cysts include infection and fistulization, where they may cause rectal pain.