Gluteal Calcifying Aponeurotic Fibroma: An Exceptional Location of a Rare Fibroblastic Tumour: A Case Report

Calcifying aponeurotic fibroma (CAF) is a rare, benign but locally aggressive fibroblastic tumour classically involving the palms and soles of children and adolescents. Occurrence in atypical locations presents substantial diagnostic challenges. Gluteal involvement of CAF is exceedingly rare, we report a case of CAF arising in the gluteal region of a man in his twenties who presented with a four-year history of a slow-growing mass and recent pulling pain. Physical examination revealed a firm, ill-defined, deeply adherent mass with a striking gritty texture on palpation and scattered white spots on the overlying skin. Ultrasonography demonstrated a hypoechoic subcutaneous nodule containing internal hyperechoic foci consistent with calcifications. Complete surgical excision was performed, and histopathology revealed the diagnostic triad of CAF. At the 9-month follow-up (prior to submission), no recurrence or complications were observed, and the patient had returned to normal activities. This case highlights that CAF can occur in non‑acral sites such as the buttock, expanding the differential diagnosis of calcified subcutaneous nodules in young adults. The characteristic gritty texture may provide a valuable bedside diagnostic clue. Complete surgical excision with clear margins remains the mainstay of treatment.