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Pilonidal sinus is a very common disease and its most frequent location is in the presacral area. Other locations are extremely rare. We describe the case of a 28-years-old white man, a baker by profession, with a swelling around the right side of the anus, pain with burning, itching and seropurulent secretion wich had been present for 7 months. A physicial examination demonstred the presence of multiple cutaneous fistulas. A fistulography and the endoscopy demonstred the absence of fistulas-in-ano. Moreover, MRI confirmed the diagnosis of a perianal mass not communicating with the anal canal. Surgical exploration revealed the presence of hair and an excision of the mass with fistulas was performed. Healing was rapid and uncomplicated. Perineal pilonidal sinus with foreign body inflammatory reaction was the histological diagnosis.
