Folliculosebaceous cystic hamartoma presenting as a large scalp mass

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma, composed of follicular, sebaceous and mesenchymal elements, that usually presents as a small papule or nodule on the central face. We report the case of a man in his early 30s with a 10-year history of a large, reddish to violaceous scalp mass measuring 4.5 cm in greatest dimension. The initial clinical impression was a cylindroma. Histological examination revealed a dermal lesion with multiple sebaceous lobules clustered around a central infundibular structure within a fibrovascular stroma separated by cleft-like spaces. This case highlights an unusual clinical presentation and the importance of considering FSCH in the differential diagnosis of scalp masses.