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JAMA Surgery Clinical Challenge |

Giant Perianal Mass QUIZ

Goran Šantak, MD, PhD1,2; Damir Matoković, MD, PhD1,2; Irena Gašparić, MD3
[+] Author Affiliations
1Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia
2Department of Surgery, County Hospital Požega, Požega, Croatia
3Department of Neurology, County Hospital Požega, Požega, Croatia
JAMA Surg. 2015;150(11):1089-1090. doi:10.1001/jamasurg.2015.0968.
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A 65-year-old man had a painful anal mass and fecal incontinence. The anal lesion appeared 1 year earlier and grew slowly to the current size. The patient reported bleeding from the rectum after defecation and denied weight loss or fever. What is your diagnosis?

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Figure 1.

Clinical photograph of the giant perianal mass in the left perianal region (A) and abdominal computed tomographic scan showing the mass in the anus (B).

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Figure 2.

Microscopic findings of the anal adenocarcinoma (hematoxylin-eosin, original magnification ×40).

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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