Abstract
Epidermoid cysts are benign lesions arising from ectodermal epithelium and are most commonly located in the skin or subcutaneous tissue. Pelvic localization is rare. This article presents the case of a 41-year-old woman who presented with pelvic pain and was found to have an adnexal cystic mass on preoperative ultrasound and magnetic resonance imaging. During laparoscopic excision, a massive 15-cm cyst originating from the rectovaginal space was identified. Histopathological examination confirmed an epidermoid cyst. This case highlights that rectovaginal epidermoid cysts should be considered in the differential diagnosis of apparent adnexal masses when both ovaries appear normal, and that complete laparoscopic excision can provide both definitive diagnosis and treatment.