Background: Rare developmental anomalies, distinct from the primary genitalia, can present as phallic-appearing outgrowths in the perineal region. Case Report: We report the case of a male infant with a perianal outgrowth resembling an accessory penis, about 3.5 cm long and 1 cm in diameter, phallic-like structure, which underwent surgical excision. Histological examination revealed mature adipose tissue (shaft region), admixed with smooth muscle bundles (Desmin-positive), nerve fibers (S100-positive), and blood vessels (CD34-positive) (glans region). Discussion: This case contributes to the limited existing literature by providing comprehensive clinical, radiological, histological, and immunohistochemical correlations, thereby facilitating a deeper understanding and differentiating the lesion from true diphallia or intersex conditions. Our findings underscore the need for multidisciplinary evaluation and thorough histopathological confirmation for accurate diagnosis and management. Conclusions: This case highlights the importance of thorough clinical evaluation and histopathological correlation in distinguishing rare congenital soft tissue lesions that may mimic genital anomalies.
Hakami et al. (Thu,) studied this question.