QBANK A 55-year-old,HIV-positive man has a fungating mass growing out of the anus. He can feel it when he wipes himself after having a bowel movement, but i

[DianaZ]

A 55-year-old,HIV-positive man has a fungating mass growing out of the anus. He can feel it when he wipes himself after having a bowel movement, but it is not painful. For the past 6 months, he has noticed blood on the toilet paper, and from time to time there has also been blood coating the outside of the stools. He has lost weight, and he looks emaciated and ill. On physical examination, the mass is easily visible. It measures 3.5 cm in diameter, is fixed to surrounding tissues, and appears to grow out of the anal canal. He also has rock-hard, enlarged lymph nodes on both groins, some of them as large as 2 cmin diameter. Which of the following is the most likely diagnosis?

A. Adenocarcinoma of the rectum
B. Condyloma acuminata of the anus
C. External hemorrhoids
D. Rectal prolapse
E. Squamous cell carcinoma of the anus