Necrotic Cyst
Tier 2 Epic necromancy
Casting Time: 1 action
Range: Touch
Components: V, S, M (a rag soaked in the blood of a plague victim)
Duration: 1 year
Your touch infests a creature with the vilest of disease that festers and churns with raw evil. Make a melee spell attack against a flesh-and-blood creature within reach. On a hit, you infest the creature with a necrotic cyst which takes up residence within its body. If the creature is immune to disease, it is not immune to the necrotic cyst, but your spell attack against the creature is made at Epic disadvantage. The cyst is a complex disease that can take many forms. When you infect a creature with the disease, you may select which form the cyst initially takes. As an action while you are on the same plane as the creature infected by the cyst, you may change the form of the cyst to a different one. An Epic creature can attempt a Constitution saving throw at the end of each of its turns. Once two successful Constitution saving throws have been made in this manner, the effect ends. The spell immediately ends if you cast it again before the duration ends.
Benign Cyst. The cyst lies dormant within the creature, becoming nearly undetectable. Non-Epic magic is unable to detect the cyst and the creature can no longer attempt Constitution saving throws to end the effect. A benign cyst can be surgically removed by a creature using a healer’s kit to succeed on a Wisdom (Medicine) ability check versus your spell save DC.
Emaciating Cyst. The creature’s body rapidly withers as the cyst consumes its life force, reducing it to a hunched, crippled state. The creature cannot take bonus actions or reactions and has Epic disadvantage on Strength, Dexterity, and Constitution saving throws.
Hungering Cyst. The creature’s body is consumed from the inside by the cyst. At the start of each of the creature’s turns, it takes 8d8 points of necrotic damage. If the target is slain while under the effects of the hungering cyst, each creature within 5 feet of the creature must succeed on a Constitution saving throw or become infected with a necrotic cyst for the remainder of the spell’s duration.
Liquidating Cyst. The cyst explodes outward in a shower of gore and body parts. If the creature has 100 hit points or fewer, it is slain instantly. Otherwise, the creature takes 20d6 points of necrotic damage and the spell ends.
Oppressing Cyst. The creature’s head visibly swells as the cyst relocates to its brain. The creature is charmed and has Epic disadvantage on Intelligence, Wisdom, and Charisma saving throws.
Ref: ELCR p100