PMC4334489_01
Intraoperative photograph showing a nodular lesion at the left lateral position of the upper anal canal.
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Digital rectal exam showed a mobile, pale-yellow, 1-cm nodular lesion at the left lateral position of the upper anal canal with a smooth surface (Fig. 1).
Endoanal ultrasound demonstrating the location and position of a metachronous adenocarcinoma of the anal canal.
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Endoanal ultrasound demonstrated a 1 by 0.6 cm nodule at the left lateral position of the upper anal canal without evidence of sphincter involvement or adenopathy (Fig. 2).
Intraoperative photograph after wide local excision of a metachronous adenocarcinoma of the anal canal.
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Shortly thereafter, the patient underwent a transanal excision of the lesion with 1-cm margins of normal-appearing tissue (Figs. 3 and 4).
Gross pathologic specimen after transanal excision of a metachronous adenocarcinoma of the anal canal.
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Shortly thereafter, the patient underwent a transanal excision of the lesion with 1-cm margins of normal-appearing tissue (Figs. 3 and 4).