PMC7708865_01
Perianal mass.. Large, irregular perianal ulcerated mass with multiple fistula tracts.
gr1.jpg
PMC7708865_01_gr1.jpg
fig0005
Physical examination revealed a large irregular perianal ulcerated mass with multiple fistula tracts (Fig. 1).
Magnetic resonance image (MRI) findings.. MRI showed perianal fistula and associated perianal multifocal abscess cavity. There was no evidence of lymphadenopathy in perirectal space, both internal iliac vessel area.. (a) T2 weighted Magnetic resonance imaging. Axial view.. (b) T2 weighted Magnetic resonance imaging. Sagittal view.
gr2.jpg
PMC7708865_01_gr2.jpg
fig0010
Magnetic resonance imaging (MRI) showed perianal multifocal abscess, however, there were no findings indicating malignant characteristics or lymphadenopathy (Fig. 2).
PMC7708865_02
Perianal mass.. Two years later from initial visiting. Huge multinodular mass with mucinous material in anal canal with extension to the subcutaneous tissue and overlying skin.
gr3.jpg
PMC7708865_02_gr3.jpg
fig0015
The mass extended widely in the perineum and buttock areas (Fig. 3).
MRI findings.. MRI showed 12 x 11 cm sized huge mass with extension to external anal sphincter and levator ani muscle. There was no evidence of lymphadenopathy in perirectal space and both pelvic wall.. (a) T2 weighted Magnetic resonance imaging. Axial view.. (b) T2 weighted Magnetic resonance imaging. Sagittal view.
gr4.jpg
PMC7708865_02_gr4.jpg
fig0020
MRI showed 11.8 cm x 10.1 cm sized mass in the perineal area, which penetrated external anal sphincter and levator-ani muscle without any evidence of lymph node involvement in the pelvic cavity (Fig. 4).
Postoperative wound.. Bilateral V-Y advancement flap.
gr5.jpg
PMC7708865_02_gr5.jpg
fig0025
The patient underwent laparoscopic APR with wide perineal skin excision, wound debridement and coverage with bilateral V-Y advancement flap via a one-step procedure (Fig. 5).