A 37-year-old male presented with a swelling that had been present for approximately 1–2 years. The swelling was gradually persistent, with no associated pain, redness, or inflammatory symptoms. His past medical history was unremarkable. His past surgical history was negative. There was no significant family history. He was not taking any regular medications and had no known drug allergies. Local examination revealed a well-circumscribed, smooth, dome-shaped swelling over the right infraorbital (malar) region, measuring approximately 2–3 cm in greatest diameter. The swelling produced mild facial asymmetry with a visible prominence of the right cheek. The overlying skin appeared normal, with no erythema, ulceration, punctum, or discoloration. No visible dilated vessels or signs of inflammation were present. The remainder of the facial examination was unremarkable.

Ultrasound demonstrated a well-defined thin-walled cystic lesion within the skin and subcutaneous tissue of the right side of the nose, measuring 22 × 27 × 17 mm. The lesion contained internal echoes and showed mild compression of the adjacent soft tissues without evidence of surrounding tissue invasion. The sonographic appearance was most consistent with a dermoid or epidermoid cyst. The thyroid gland was normal in size, with the right lobe measuring 50 × 17 × 16 mm, the left lobe 47 × 14 × 13 mm, and an isthmus thickness of 2 mm. Both thyroid lobes demonstrated homogeneous echotexture and normal vascularity, with no focal thyroid lesions. No significant pathological cervical lymphadenopathy was identified. The bilateral parotid and submandibular glands were normal in appearance, with no focal lesions.

Under general anesthesia and in the supine position, an elliptical skin incision was made over the right nasal lesion. The mass was completely excised (excisional biopsy) with preservation of the surrounding tissues. Hemostasis was secured meticulously. The wound was then closed in anatomical layers, with approximation of the subcutaneous tissue followed by skin closure. The patient tolerated the procedure well and was transferred to the recovery unit in stable condition.

Histopathological examination of the excised right cheek mass revealed a simple apocrine cyst. Microscopically, the cyst was lined by a double layer of benign epithelium, consisting of an inner layer of oncocytic cells with abundant eosinophilic cytoplasm and an outer cuboidal cell layer, without cytological atypia. No evidence of malignancy was identified.

The patient had an uneventful postoperative recovery following excision of the right cheek mass. The surgical wound healed well, with no evidence of infection, hematoma, or wound dehiscence. Histopathological examination confirmed a benign simple apocrine cyst with no evidence of malignancy. The patient was reassured and advised to attend routine outpatient follow-up for wound assessment and suture removal.