Laparoscopic resection for a relapsed presacral epidermoid cyst penetrating the ischiorectal fossa

An epidermoid cyst occurring in the presacral region is a rare congenital cystic tumor. Complete surgical excision is recommended because of the possibility of infection and malignancy. Depending on the size and location, several approaches, such as anterior, posterior, combined, and laparoscopic approaches, have been described. Here, we have reported a rare case of relapsed epidermoid cyst after emergency laparotomy and transvaginal drainage. Although the cyst penetrated the levator ani muscle and was densely adhered to the vagina and rectum, complete laparoscopic resection was successfully performed. This approach is a useful technique as it is minimally invasive and minimizes tissue destruction of the pelvic floor.