PMC4855499_01
Preoperative 360  transanal ultrasound (A). Postoperative 360  transanal ultrasound (B).
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Its dimensions were 2 cm width and 2 cm length in the anal canal (Fig. 1A). At 1 year follow-up the patient had not tumour-related symptoms or fecal incontinence and any signs of local recurrence at ultrasound imaging were demonstrated (Fig. 1B).
Surgical excision (A). Spincteroplasty (B). Specimen (C).
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A perianal linear incision and blunt dissection in the intersphincteric space was performed identifying the lesion (Fig. 2A). After its complete excision a considerable thinning of the internal anal sphincter was detected so that a side-to-side sphincteroplasty was carried out (Fig. 2B). The specimen was 2 cm x 2.8 cm (Fig. 2C) and a cross section of the lesion showed a typical fibrous capsule.
Negative immunostain for CD34 (A) and CD117 (B). Positive immunostain for actin (C) and desmin (D). Nuclear positivity for estrogen receptors (E).
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The histo-pathological examination through immunohistochemistry, investigating the expression of actin, desmin, CD34 and CD117 (Fig. 3), confirmed the preoperative suspicion of leiomyoma.