Case history
Case history
A 50-year-old man presents to his family physician with bright red blood per rectum. He denies anal pain or trauma, a history of HIV or high-risk sexual partners, immunosuppression, or other constitutional symptoms. Anal continence is normal. On examination there is a 1.5 cm firm mass in the anal canal. There is no invasion of the prostate. His abdomen is soft and there is no abdominal tenderness. Bilateral inguinal nodes are clinically negative. His full blood count is normal.
Other presentations
The most common presenting symptom of anal cancer is bleeding. Other common symptoms are anal pain and the sensation of a mass.[3] Other less common symptoms include itching, anal discharge, faecal incontinence, fistulae, or a non-healing ulcer.[4]
Commonly, patients and their physicians attribute such symptoms to haemorrhoids for many months preceding the diagnosis.[3] This underscores the importance of performing an anorectal examination for patients with such symptoms. Benign rectal bleeding due to haemorrhoids is a diagnosis of exclusion.
Use of this content is subject to our disclaimer