Giant cystic neck tumor: diagnostic and therapeutic challenges of a rare cutaneous malignancy – a case report

Syringocystadenocarcinoma papilliferum (SCACP) is a rare cutaneous adnexal neoplasm that may arise from head and neck subsites & often mimic other cystic lesions of neck. We report a case of a giant cystic neck swelling occupying the entire left half of neck posing diagnostic & therapeutic challenges. A nil comorbid man in his 90s presented with a progressive lateral neck swelling for 2 years. An Initial fine needle cytology was non-diagnostic. Magnetic resonance imaging demonstrated extensive involvement by the lesion across both the anterior and posterior triangles of the neck. The tumor was excised by transcervical approach. Final histology with cytokeratin 7,19 & SOX10 positivity suggested SCACP. This case highlights SCACP's potential for massive, non-infiltrating growth in the neck, distinguishable from other cystic lesions through histology & immunohistochemistry. Successful transcervical excision in a geriatric patient, despite inherent challenges & low tumor aggressiveness reinforces the value of surgical management.