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Gross Pathology: Anal squamous cell carcinomas are usually located distal to the dentate line. An exception is basaloid carcinoma, which often arises proximal to the dentate line and may not be visible on external examination.

Initially, the lesions are small and mobile with a polypoid or verrucoid appearance. They may grow proximally into the rectum and be indistinguishable from primary rectal adenocarcinomas.

When the lesions grow distally, they may involve perianal tissues and be visible at the anal verge. The anal skin involvement may produce ulceration and mimic an inflammatory process. In advanced cases, they can appear as ulcerating, fungating masses protruding from the anal opening (as seen in this case; see previous image for case history).

Case courtesy of: Dr. Sanjay D. Deshmukh (Professor of Pathology) and Dr. Ninad J. Gadekar (Consultant Oncosurgeon), Dr. Vithalrao Vikhe Patil Foundation's Medical College & Hospitals, Ahmednagar, India.

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