In this case, the gynecologist suspected a pelvic abscess because of mild leukocytosis, pelvic tenderness, and a history of pelvic surgeries. So that MRI is requested which shows features consistent with inclusion cyst. After that, the patient undergoes laparoscopy which confirms the inclusion cyst, and no abscess was found. The patient's symptoms are not significantly improved, the surgical and urologic consultations were free and they said nothing to do.

Inclusion cysts are non-neoplastic reactive mesothelial proliferation, seen exclusively in child-bearing age women with a history of previous surgeries (abdomen or pelvis) or endometriosis.

Normally, the peritoneum can absorb the ovarian fluid easily, however when the presence of previous peritoneal insult (inflammation, surgery, trauma, endometriosis, and adhesions) the absorptive capacity is decreased and the fluid accumulates and contained within the adhesions forming a pseudocyst which can be very large occupying the abdomen and pelvic cavity.