Syringocystadenoma papilliferum (SCAP) is a rare, benign tumour with varied presentations that arises from the apocrine glands and at times can lead to a diagnostic dilemma. A 53-year-old male presented with a 40-year history of a scalp nodule and a recent 2-year change in its character, and a sanguinopurulent discharge. Examination revealed a 4 cm × 2 cm firm nodule upon left side of the scalp vertex, actively discharging pus and blood. No regional lymph nodes were noticeably palpable. Incision biopsy performed elsewhere showed evidence of a squamous cell carcinoma-in-situ. He underwent a wide local excision with a bilobed flap reconstruction. Histopathologically, the lesion was reported to be SCAP. On follow-up, the patient has since remained asymptomatic with an acceptable cosmetic recovery.
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