Mold or water spots. Can't tell for sure.
How valuable is this image?
Are you willing to take the risk of experimenting on it?
I assume your scan is for preservation purposes. Right? While it won't be an easy job, the image can be digitally restored if you are willing to work. I have restored images that are almost as bad.
What does the surface of the emulsion look like? Is it bubbled or does it show evidence of fungus, etc., on the surface?
Do you have another part of that film that can be used for experiments? (e.g. Another frame of the same strip that is similarly damaged?)
Try soaking that (hypothetical) part of the film in tepid water and Photo-Flo. Also try alcohol.
If those things don't remove or mitigate the problem it is a sure thing that the damage is permanent and the only way to restore the image will be with digital methods.
Unfortunately, even with digital, this will be quite a task to restore and you are unlikely to get perfect results. You can get "good" results if you are willing to work at it but the amount of work you do will be directly proportional to the importance of the image.
If it's a valuable image, you will, of course, be more willing to work. If it's an "everyday" image, you're probably better off cutting your losses, falling back on your digital copy, tossing out the film (to prevent it from contaminating other film) then taking that as a lesson on how to keep your film safe in the future.