A patient with tuberous sclerosis having a peculiar cauliflower-like growth on the face is reported. The histological findings even in this unusual clinical picture support the findings of Nickel and Reed1 that adenoma sebaceum must be a hamartoma chiefly of collagenous tissue with other changes being secondary. A review of many papers with their photographs as well as the classification of Butterworth and Wilson2 fail to show or mention the unusual cauliflower-like growth seen on the face of this patient with tuberous sclerosis.