Implantation metastasis from colorectal cancer into haemorroidectomy wound is very rare. The management of this condition remains controversial. We report a case of 68-year-old man with perianal soft tissue lesion biopsied and histopathology revealed an adenocarcinoma. Further investigation by colonoscopy and computed tomography scan revealed rectal adenocarcinoma. Pathological examination confirmed that this lesion was a distant metastasis from rectal cancer. The case was discussed at the multidisplinary meeting and the patient was advised to undergo long course neoadjuvant chemoradiotherapy followed by anterior resection and local excision of perianal metastasis. This case will be treated with long course neoadjuvannt chemoradiotherapy and after six weeks from treatment completion the plan is to perform sphincter sparing anterior resection and local excision of perianal implanted tumor.
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