Malignant tumors of anal margin and perianal skin are rare, which accounts for approximately 2%-3% of all anorectal malignancies. Because of the variable presentation and pathologic similarity to benign anal lesions, the diagnosis and treatment is often delayed. We report the case of a 54-year-old Indian male who presented with non-healing anal fistula which progressed to a large chronic ulcer and was later diagnosed as anaplastic large cell lymphoma of perianal skin. Primary cutaneous anaplastic large cell lymphoma (PCALCL) of perianal area has been rarely reported, that too masquerading anal fistula is being reported for the first time.
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