Obstructive perianal lesion in a 75-year-old man. (16th July 2012)

• Record Type: Journal Article
• Authors: Maitra, Rudra Krishna; Pinkney, Thomas; Subramonia, Sriram; Acheson, Austin G
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-07-16
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr.01.2012.5667
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 75-year-old man presented with a fungating peri-anal mass which appeared malignant at presentation and required a defunctioning colostomy due to abdominal distension. Multiple biopsies were negative for malignancy and CT/MRI scans showed no malignant mass. A provisional diagnosis of prolapsed haemorrhoids was made and the mass was treated with sugar and charcoal dressings. There was a dramatic resolution of the mass with this treatment and the patient was discharged 1 month post-admission. The patient then underwent an elective haemorrhoidectomy by which time the mass had decreased to a perianal skin tag. The only clues in this case were the acute presentation of the mass, the fact that the mass had appeared post-defecation and that the patient had been diagnosed with haemorrhoids 2 years previously on colonoscopy. This case highlights the importance of evaluating all investigations and considering all differential diagnoses before embarking on definitive management.