Cavernous Hemangioma of the Anal Canal Mimicking a Neoplasm: A Rare Cause of Lower Gastrointestinal Bleeding Successfully Treated With Transanal Excision

TL;DR

A rare case of anal canal cavernous hemangioma was successfully treated with transanal excision after being misdiagnosed as a tumor.

Contribution

Presents a rare case of anal canal cavernous hemangioma successfully treated with transanal excision and highlights diagnostic and treatment approaches.

Findings

MRI was effective in identifying a vascular malformation in the anal canal.

Transanal full-thickness excision resolved symptoms with no recurrence at three months.

Cavernous hemangiomas should be considered in differential diagnoses for anorectal bleeding.

Abstract

Cavernous hemangiomas of the anal canal are exceptionally rare vascular malformations that may present with chronic rectal bleeding and are often misdiagnosed as hemorrhoids or neoplastic lesions. We report the case of a 75-year-old female patient with a one-year history of painless rectal bleeding and a soft polypoid lesion located 2 cm from the anal verge, within the anterior wall of the anal canal. Magnetic resonance imaging (MRI) revealed a hyperintense pseudonodular lesion consistent with a vascular malformation. Histopathological examination after biopsy confirmed the diagnosis of cavernous hemangioma. Definitive treatment was achieved through transanal full-thickness excision, with complete resolution of symptoms and no recurrence at the three-month follow-up. This case highlights the importance of including vascular lesions in the differential diagnosis of anorectal bleeding and illustrates the utility of MRI and organ-preserving surgery in the management of anal canal hemangiomas.

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