A Rare Case of a Giant Pelvic Retroperitoneal Epidermoid Cyst

A seventy year old multiparus lady presented with progressive swelling in the abdomen. Clinical examination confirmed a large mass in the abdomin. The ultrasound showed a giant 35 cm abdomino-pelvic echogene mass, extending from the pubis symphysis to the epigastric region, displacing the liver, spleen and the urinary bladder. The computed tomography showed similar finding (figure 1). A giant ovarian cyst was diagnosed. Median laparotomy was performed and a 30 cm retroperitoneal cyst was found. Ovaries and uterus were normal. Uneventful cyst cleavage was performed after liberation of some intestinal and epiploic adherences (figure 2). The cyst contained sebaceous matter and histological examination shows that the cystic wall was lined with flattened squamous epithelia with a distinguished granular layer. The cystic space was filled with a large amount of keratinized material. The histology was compatible with an epidermoid cyst. The post operative course was uneventful and the patient was doing well at the 5 months follow-up visit.