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Figure legend:
Figure 1: Multi-lobulated soft cystic swelling measuring 20 *17 *10 cm swelling over the left upper back and shoulder
Figure 2: ultrasound results showed a large, well-defined, lobulated, heterogeneous hypoechoic lesion with numerous small calcifications
Figure 3: histopathology revealed a cyst with a stratified squamous epithelium lining that contained keratin.
Figure 4: Romovac drain was inserted and the skin was closed with Ethilon 2-0 mattress sutures