74 y.o. male referring intermittent rectal bleeding for almost 1 year

71 years old male, heavy smoker. Twenty years before he had an episode of upper gastrointestinal bleeding due to hypertrophic duodenitis. During that episode he suffered a permanent amaurosis in his left eye due to neuritis optica.

 

Present complaint is related to intermittent rectal bleeding of small amount since almost one year earlier. Lately, he was also suffering from constipation. Physical examination of the rectum showed a probable tumor at 12 h.

Colonoscopy  examination: At 1-2 cm from anal margin a irregular and enlarged fold of the rectal mucosa with erosions. Some polyps were also detected at 3 and 7 cm, respectively.

 

The slides shown below correspond to the biopsy of the anal-rectal junction (1-2 cm from anal margin).

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