Year: 2026 | Month: August | Volume: 13 | Issue: 8 | Pages: 458-461
DOI: https://doi.org/10.52403/ijrr.20260847
A Pedunculated Monster Mimicking Malignancy in an Immunocompromised Individual: A Case Report and Review of Literature
Dr Kevin Neeraj Karodi1, Dr Ananda B. B2, Dr Zaiba3, Dr Nitin4, Dr Santosh5
1MS Student, Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore
2Professor, Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore
3,4,5Senior Resident, Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore
Corresponding Author: Dr Kevin Neeraj Karodi
ABSTRACT
Sebaceous cysts are common, benign, encapsulated subepidermal nodules that rarely undergo malignant transformation. Cysts larger than5 cm are termed giant sebaceous cysts, and when complicated by infection, ulceration, or a foul-smelling discharging mass, the eponym ‘Cock’s peculiar tumor’ is applied. We report the case of a 75-year-old, hepatitis C virus (HCV)-positive gentleman who presented with a progressively enlarging, painless, pedunculated swelling over the left occipito-parietal scalp of five years’ duration, associated with foul-smelling, blood-tinged discharge for one week. On examination, a 10 × 8 × 4 cm firm, non-tender, pedunculated swelling with multiple ulcerated areas was noted. Contrast-enhanced computed tomography of the brain showed a large lobulated, heterogeneous soft-tissue-density scalp lesion without intracranial extension. The clinical appearance raised strong suspicion of cutaneous malignancy. The swelling was completely excised under local anaesthesia along with its capsule, and the postoperative course was uneventful. Histopathological examination revealed features suggestive of a sebaceous cyst with no evidence of malignancy. This case highlights that giant, ulcerated, and discharging scalp swellings, though alarming in appearance, may still represent benign pathology, and underscores the importance of preoperative imaging and mandatory postoperative histopathological confirmation in every giant cutaneous cyst before malignancy can be excluded
Keywords: Sebaceous cyst; Giant cyst; Cock’s peculiar tumor; Scalp swelling; Immunocompromised; Case report.
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