Differentials
Hemorrhoids
SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS
Rectal pain and bleeding can occur with both hemorrhoids and anal cancer, and they are often difficult to distinguish on the basis of symptoms.
Physical exam reveals no palpable mass with hemorrhoids.
INVESTIGATIONS
Biopsy is negative for malignancy in hemorrhoids.
Rectal cancer
SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS
Difficult to distinguish on the basis of symptoms. Rectal cancer causes a rectal mass rather than an anal mass.
INVESTIGATIONS
Colonoscopy to identify a mass in the rectum. Biopsy shows adenocarcinoma.
Anal margin cancer
SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS
Indistinguishable from anal canal cancer on the basis of symptoms. On physical exam, the tumor is located in the perianal skin and does not involve the anal verge.
INVESTIGATIONS
No tests can differentiate anal margin cancer from anal cancer.
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