A 61 years old male patient presented to the AE Department reporting bleeding during defecation, difficulty and low pain while walking and sitting.On physical examination we saw an Gearbox exophytic cauliflower like, ulcerated Riding Helmet Covers tumor mass measuring 20 x 14 cm that covered the whole perineum and a similar satellite lesion 3 x 4 cm, with malodorousness.The mass was there for at least three years, progressively growing.