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We report a typical case of Cowden disease or Multiple Hamartoma Syndrome in a 32 year old female without a family history of this illness. The patient suffered bilateral fibrocystic disease of the breast, having been subjected to mastectomy because of carcinomatous degeneration. She complained of gastric symptoms, and the x-ray examination showed multiple polyposis. On physical examination an asymptomatic thyroid nodule was noted. The skin showed multiple wart-like lesions, lichenoid papules, localized hyperkeratosis and pigmented spots. She had many papillomas in her mouth a rasberry tongue and bilateral perleches.

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