Presacral epidermoid cyst with right hydronephrosis

Objective: Epidermoid cyst of the presacral space is a rare congenital lesion of ectodermal origin. Presacral epidermoid cyst with hydronephrosis is even rarer and has never been reported in Taiwan. Herein, we present a patient with presacral epidermoid cyst with right hydronephrosis. Case Report: A 62-year-old woman had low abdominal pain for 2 weeks and was referred to our hospital for further management. In our hospital, computed tomography revealed a multilobulated cystic tumor (20 × 15 × 12 cm) in the lower abdomen, complicated with right severe hydronephrosis. Laparotomy was undertaken and a presacral tumor was removed. The pathologic diagnosis was an epidermoid cyst. Conclusion: A presacral epidermoid tumor is a rare tumor and a large presacral cystic tumor may mimic an ovarian tumor in imaging. All presacral tumors with or without symptoms should be evaluated thoroughly before operation. Complete surgical excision, preserving adjacent organs' function, should be kept in mind.