An unusual presentation of rectal leiomyoma

Certain tumor characteristics are suggestive of malignancy, including tumor size greater than 5 cm, tumor cell necrosis, ulceration, cellular atypia, and the presence of three or more mitotic figures/10 high-powered fields.1,2 Transrectal ultrasound (TRUS) may also help in differentiating benign and malignant disease, the latter presenting with disruption of normal tissue planes, cystic degeneration, and lymphadenopathy on ultrasonography.3 Although the patient in this account did not undergo TRUS, the radiographic finding of a tumor size greater than 5 cm heightened the preoperative risk for malignant degeneration.