May be tumor: Within 1 cm. of anal canal, the most common palpable lesion is a thrombosed hemorrhoid. At the same time one must be able to r.o. a malignant tumor such as squamous Ca or even an adenoCa. Mets can rarely be found there. While tumors can be rough, sharp is not a typical description unless there is something swallowed that impacts into anal canal. Bx underanoscopy needed.
Answered 11/27/2015
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