Multiple biopsies were taken at the anorectal junction
and pathology was consistent with high-grade TCC of the colonic epithelium (Figure 2).
Microscopic examination confirmed the existence of an infiltrative tumor disease extending into the muscle layers in the anal canal and involving the anorectal junction
Perineal descent of the anorectal junction
more than 3 cm below the pubococcygeal line during maximal straining is a diagnostic finding on imaging.
Repeat colonoscopy revealed a circumferential non-pigmented poorly-differentiated low rectal tumour at the anorectal junction
It is unusual to find systemic failure in the absence of liver metastases, although the portosystemic shunting that exists at the anorectal junction
does permit hematogenous spread outside the portal circulation to the internal iliac vessels and the cava.
The puborectalis muscle surrounding the anorectal junction then relaxes to allow the straightening of the anorectal angle.
It accentuates the action of the puborectalis by also pulling the anorectal junction forward anteriorly to further increase the anorectal angle.
During evacuation, the anorectal junction moves down and backward and the pelvic floor usually descends slightly.
A probe placed through the external opening of the abscess identified the fistulous tract, which extended to the anorectal junction
Grinvalsky NT, Helwig EB: Carcinoma of anorectal junction
5-cm thickening of the rectum and sigmoid colon from the anorectal junction to the mid-sigmoid (Fig.
The lesion was noted to extend from the anorectal junction to the mid-sigmoid colon; ii) Posterior and left sided bladder wall thickening indicating a large mass in the bladder wall.