Abstract
A 35-year-old man, previous smoker, with ulcerative colitis and ileal pouch-anal anastomosis since 2010 presented with rectal bleeding and perianal pain and drainage. He was initially thought to have a rectal fissure, which was treated topically. Because of ongoing symptoms, he was referred to our institution. On digital rectal examination, a fleshy, fungating, and circumferential mass was palpated at the level of ileal pouch-anal anastomosis. Magnetic resonance imaging showed a 3.6 × 3.5 × 4.7 cm mass with mucinous and hypoenhancing solid components extending from the ileal pouch-anal anastomosis to the superior anal canal (Figure A).
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