Mass protruding out of anus since last 2 years
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An enhancing irregular mass forming thickening of distal rectum and anal canal, invading transmurally into internal and external anal sphincters, levator ani, perianal fat and bilateral ischiorectal fossae more prominently on the right side. Inferiorly the lesion is involving the anal notch and subcutaneous fat in bilateral gluteal cleft more prominently on the left side.
A fistulous tract is visualized parallel to the anal canal and directed diagonally posteriorly downwards on the right side.
There is right anterior perirectal and bilateral superficial inguinal lymphadenopathy.