AbstractWe report a case of a perineal fibroadenoma initially diagnosed on ultrasound and magnetic resonance imaging as a soft tissue sarcoma in a 35-year-old female. Following wide local excision, histopathology revealed the lesion as a vulval fibroadenoma. We provide an overview of the literature and highlight the need to consider fibroadenoma, arising from ectopic breast tissue, as an important differential for general surgeons and gynaecologists caring for patients with perineal masses.