Male patients presenting to the mammography department for workup of breast disease is an overall rare event compared to females. Gynecomastia is statistically the most common breast condition afflicting male patients, with ductal carcinoma an uncommon secondary diagnostic consideration. Secondary benign breast conditions or mimickers of breast disease in men are even rarer than primary carcinoma and can pose a significant challenge in breast imaging workups. We present a challenging workup of a superficial epidermoid cyst (EC) in a male patient with significant subcutaneous growth and indeterminate imaging characteristics, mimicking a breast neoplasm. Furthermore, we present undesirable consequences of performing a biopsy of an EC including rupture and abscess formation. © 2019 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.