[Pre-sacral cyst as differential diagnosis to recurrent pilonidal cyst with abscess].

A 31-year-old man presented with a recurrent abscess in the gluteal cleft. It was interpreted as a pilonidal sinus and he underwent surgery several times. The modified Bascom's asymmetric midgluteal cleft closure technique was used without satisfying clinical remission. Endoscopy, magnetic resonance imaging and transrectal ultrasound visualized a pre-sacral cyst, which was excised in toto with laterosacral approach of Kraske. A histological examination showed epidermal inclusion cyst. The post-operative course was uneventful.