A 43-year-old Caucasian female presented with a pedunculated perianal lesion. Physical examination revealed a subepithelial tumor at the anal verge for which she received an excisional biopsy without complications. Gross examination revealed a tumor that measured 2.4 cm at the greatest diameter. It was gray-white, firm, and well circumscribed. The perianal skin overlying the tumor appeared grossly normal.
Representative images of the lesion are shown. What is the best diagnosis?
a. Fibroadenoma
b. Benign phyllodes tumor
c. Malignant phyllodes tumor
d. Hidradenoma papilliferum of skin adnexal appendage
e. Periductal stromal sarcoma
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Submitted by John Wolz, Attending Surgeon, Wray Community District Hospital, Wray, Colorado, USA
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