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|Poll|March 26, 2015

Management of a 53-Year-Old Anal Cancer Patient

A 53-year-old man treated for squamous cell carcinoma of the anus presents 4 weeks post-treatment with a 2-cm anal mass. What is the most appropriate next step in his management?

A 53-year-old man presents with a 4-cm anal tumor. The patient is diagnosed with squamous cell carcinoma of the anus (T3, N1, M0) and completes a course of chemoradiotherapy as definitive management. Four weeks post-treatment he presents to clinic for a follow-up visit. On physical examination, a rectal exam reveals a 2-cm exophytic anal mass.

What is the most appropriate next step in his management?

A. Restaging imaging with either PET/CT or CT with contrast
B. Refer to surgical oncology for excisional biopsy
C. Cryotherapy or other local ablation of lesion performed in the office
D. Continued close observation with short-term follow-up

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