The clinical presentation, colonoscopic findings, and the CT/MRI features suggest an anorectal hemangioma/vascular malformation.
On imaging the main differential diagnosis is the hemorrhoids which can give the same appearance on T2, however, the lack of extension to the perirectal fat exclude this possibility 1.
Hemangiomas and vascular malformations are considered as rare entities 1,2. They may involve any intestinal segment, nevertheless, the small bowel is the most frequently affected 1. Anorectal and colonic involvement is rarer 1.
Additional contributor: A. Ramdani, MD