Abstract
A 14-year-old boy was admitted to Jichi Medical School Hospital with complaints of intermittent bleeding and mucous secretion from the anus. Digital examination disclosed a hard tumorous lesion circumferentially involving the lower rectal wall at 4 cm from the anal verge. Fiberscopical examination of the rectum revealed a ring form elevated lesion adjacent to the anorectal portion. The surface of the lesion were erythematous change and superficial ulceration on the top. Histological findings of biopsy specimen taken from the lesion were as follows; 1. fibromuscular obliteration in the rectal mucoua. 2, sparse round cell infiltration and the depletion of goblet cells. Those were characteristic of histological features in the lesion. In the majority of solitary ulcer of the rectum, single ulcer alone is usually found on the anterior wall of the lower rectum. In the literatures, however, solitary ulcer syndrome of the rectum with the shape just like an annular lesion with circumferential growth had been rarely reported. In such cases including the present case, it was very difficult to differentiate from rectal cancer or sarcoma only by endoscopical and radiological examinations. Histological confirmation of biopsy specimen, therefore, combined with endoscopy and X-ray examination would be extremely important to establish a definite diagnosis.
