Abstract
Carcinoma rectum often presents as painless bleeding per rectum, altered bowel habits, abdominal discomfort, and rarely as intestinal obstruction or bowel perforation. Here is a case of a patient with long standing fistula in ano who presented to Regional Cancer Centre, Thiruvananthapuram with a gluteal mass and was later diagnosed to be adeno carcinoma rectum. So far only very few cases of adeno carcinoma rectum reaching the gluteal space through peri-anal fistula has been reported in the literature.
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