Clinical diagnosis of pararectal masses remains a challenge to this day. Despite the availability of advanced imaging facilities, we often fail to reach a definitive diagnosis and have to resort to surgery. We describe a case of a 60-year-old female with a painless perianal swelling gradually increasing in size for 6 months with spontaneous reduction on assuming a supine position. Clinical examination of this patient was suggestive of a pelvic floor hernia. However, radiological investigations were suggestive of an ischiorectal abscess. In view of lack of radiological corroboration of clinical findings, patient underwent diagnostic laparoscopy which ruled out a hernia. A wide local excision of the mass was performed, which on histopathology with immunohistochemistry examination revealed an aggressive pararectal angiomyxoma.
Keywords: Angiomyxoma; Pararectal swelling; Pelvic floor hernia.
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