Soft Mass Near Rectal Junction: Could It Be a Polyp or Tumor?

There is a mass at the anal-rectal junction?

Hello, doctor.
Two years ago, I had a history of blood in my stool along with recurrent diarrhea and constipation accompanied by abdominal pain, which led to a colonoscopy.
At that time, the bowel preparation quality was rated as good, and the results showed internal hemorrhoids, with no polyps detected.
The diagnosis was irritable bowel syndrome.
However, since then, my symptoms of diarrhea, constipation, and abdominal pain have been fluctuating, and recently, I have noticed an increase in constipation.
There was also one instance where I experienced acute abdominal pain and rushed to the bathroom, resulting in a large amount of blood in my stool.
I initially thought it was a rupture of the internal hemorrhoids and did not pay much attention, but I felt uneasy about it.
Additionally, I have noticed an increase in anal discharge recently, which has made me more vigilant about colorectal cancer.
I often perform self-examinations by inserting my fingers into the anal canal.
I can feel a soft mass approximately 4 cm deep, around the area where the rectum curves near the prostate.
I would like to ask if this mass could potentially be a polyp or even a tumor? Also, considering that I had a high-quality colonoscopy two years ago, what is the likelihood of a false negative result where a polyp was not detected or was misidentified as hemorrhoids?

Yuan Yuan, 20~29 year old female. Ask Date: 2017/11/10

Dr. Ke Fangxu reply Surgery

The digital rectal examination is actually a highly specialized procedure, and even specialists need to accumulate years of experience to accurately assess subtle lesions.
Therefore, for the general public, we do not recommend performing a digital rectal examination on their own, as it not only increases the risk of accidental injury but also does not yield an accurate diagnosis.
It is advisable to visit a colorectal surgery clinic for a thorough examination by a specialist.

Reply Date: 2017/11/10

More Info

When it comes to the presence of a soft mass near the rectal junction, it is understandable to have concerns about whether it could be a polyp or tumor, especially given your medical history of rectal bleeding, abdominal pain, and previous diagnoses. Based on the information provided, there are several important points to consider regarding your symptoms and the potential implications for your health.

Firstly, the soft mass you are feeling could indeed be related to a variety of conditions. Given your history of internal hemorrhoids and the recent increase in constipation, it is possible that the mass is a result of the hemorrhoids themselves or a related issue, such as a thrombosed hemorrhoid. Hemorrhoids can sometimes feel like soft lumps and may change in size and consistency based on factors such as inflammation or the presence of blood clots.

However, your concern about the possibility of a polyp or tumor is valid, especially considering your previous episodes of rectal bleeding and abdominal pain. Polyps are abnormal growths that can develop in the lining of the colon or rectum, and while many are benign, some can be precursors to colorectal cancer. Tumors, whether benign or malignant, can also present as masses in this area.
The fact that you had a colonoscopy two years ago, which showed no polyps, is reassuring, but it is important to note that no medical procedure is infallible. There is a possibility of false negatives, especially if the polyp was small or located in a difficult-to-see area. Additionally, new polyps can develop over time, which is why regular screenings are crucial, particularly if you have risk factors for colorectal cancer.

Given your symptoms of increased rectal bleeding, abdominal pain, and the presence of a soft mass, it is highly advisable to seek a thorough evaluation by a healthcare professional. A repeat colonoscopy may be warranted to assess for any new growths or changes in the colon or rectum. It is also important to discuss your symptoms in detail with your doctor, including the nature of the bleeding, any changes in bowel habits, and the characteristics of the mass you are feeling.

In terms of the soft mass itself, if it is indeed a polyp or tumor, early detection is key to effective treatment. If it is a benign condition, such as a hemorrhoid or a benign polyp, treatment options may include lifestyle changes, medication, or minor surgical procedures. If it is malignant, early intervention can significantly improve outcomes.

In conclusion, while the soft mass near the rectal junction could be related to your history of hemorrhoids or other benign conditions, it is crucial to rule out more serious issues such as polyps or tumors. Regular screenings and prompt medical evaluations in response to new or worsening symptoms are essential components of maintaining gastrointestinal health. Please consider scheduling an appointment with a gastroenterologist or your primary care physician to discuss your concerns and determine the best course of action.

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