Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumors. They are rare in rectum. This location is a surgical challenge due to the high morbidity after aggressive surgeries. We present the case of an 81-year-old female with a high-grade GIST treated with transvaginal excision and adjunctive therapy with imatinib. The postoperative period was uneventful without anal dysfunction. Within the types of surgical treatment available, transvaginal excision is an acceptable procedure in lesions located in the rectovaginal region.

Anal canal duplication (ACD) is the rarest congenital malformation of the digestive tract and is associated with other congenital malformations. The clinical case reports a 40 years old woman who had two episodes of anal abscesses treated with surgical drainage within 1 year. In proctology consultation, the examination revealed a structure in the midline, posterior to the native anus. Pelvic magnetic resonance imaging and anal echoendoscopy confirmed the presence of a tubular structure posterior to the anal canal, compatible with duplication of the anal canal. The patient was proposed for surgical excision but refused. Seven years later, the patient had another anal abscess. She was again proposed for surgery and refused. Around 60 cases of ACD are currently described worldwide. The diagnosis is usually made at an early stage of life. Our patient was diagnosed at the age of 40 years, constituting one of the most elderly patient diagnosed with ACD.