Prominent physical findings included macrocephaly, with a head circumference of 56 cm (6 SD higher than the mean for age), occipital prominence, and 3 firm, subcutaneous, bony projections from the skull. Examination of the skin revealed a 3-cm café au lait patch on the left leg, multiple pigmented macules on the penis (Figure 1), and a verrucous plaque, 5 × 3 cm, on the posterior thigh above the popliteal fossa. A 2.5 × 2.5-cm soft, nontender mass was palpable in the anterior abdominal wall tissues (Figure 2). The joints demonstrated hyperextensibility. Examination of the child's mother revealed no physical abnormalities. The father was reportedly healthy. Findings from a biopsy of the soft tissue abdominal wall mass were interpreted as a lipoma.