Cauliflower-like lesion on the buttock: a quiz. Pedunculated lipofibroma.

A 38-year-old heterosexual man presented with a bulky mass lesion on his left buttock. A small polypoid lesion had been noted in the area since his childhood. It had grown slowly but steadily to a size of approximately 3 cm. In the past 2 years, however, there had been rapid growth. He denied any history of trauma or infection. His family history was insignificant. The patient was otherwise in good health. On physical examination, a huge flesh-coloured pedunculated lesion, approximately 15 × 13 cm in size, originating from the left buttock was noted (Fig. 1). It was soft in consistency and non-tender. There were no superficial changes, such as ulceration or bleeding. The shortest distance between the tumour base and the anal verge was approximately 4 cm. His sphincter function was intact. There were no palpable lymph nodes. A wide excision with primary closure using a local rotation flap was performed. Histopathological examination showed bundles of mature fibroblasts, mild to moderate cellularity, abundant collagen stroma, and marked increase in adipose tissue entrapped between bundles of dermal collagen fibres (Fig. 2). There was no evidence of human papillomavirus (HPV) infection.