We present the case of removal of a a breast-like soft tissue growth located adjacent to the anus is of a 42 year old woman. The patient reports that she has had this lesion since her childhood and that it gradually increased in size during her adolescence. During the period in which she was nursing her children, she noted a discharge from the most prominent portion of the mass. After evaluation a provisional diagnosis of an ectopic breast was made. Upon examination of the perineum a discrete nipple-areola complex is seen at the apex. There is a second, nipple-like structure located near the base of the mass. The mass was immediately adjacent to the anus, slightly distorting the perineal body and the vaginal introitus. Pathologic examination of the putative nipple revealed fibroepithelial architecture. The crossection through the mass proper reveals lobulated adipose tissue mixed with fibrous stroma. No glandular tissue is identified by standard microscopy. There have been only 2 cases described in the literature of ectopic breast tissue in a similar location, beyond the traditional milk line. We demonstrate the operative technique to removal of this unusual lesion.