Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 2 2018 09 23 117 120 EN George Maroudias Department of Obstetrics and Gynecology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Alina-Roxani Gouloumi Department of Pathology, Attikon University Hospital, School of Medicine, University of Athens, Athens, Greece Zoi Tsakiraki Department of Pathology, Attikon University Hospital, School of Medicine, University of Athens, Athens, Greece Maria Oikonomou Department of Obstetrics and Gynecology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece George Chrelias Department of Obstetrics and Gynecology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Charalampos Chrelias Department of Obstetrics and Gynecology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 2018 04 18 2018 09 23 A tail-gut cyst can be often a misleading clinical entity. In half of the patients there is no presenting symptom. On the other half, the patients most commonly present with a variety of symptoms such as rectal pain, constipation, lower back pain, dysuria or dyspareunia. The recommended treatment of choice for the tail-gut cyst is complete surgical excision without rupture of the cyst. We present the case of a 29-year-old female with history of dyspareunia over a 5-month period, who discovered an “ovarian” cyst during an annual scheduled ultrasound appointment. However, the intraoperative findings were surprising. The bottomline is always to keep in mind the Pandora’s Box of the retrorectal space.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/855 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/855/457