Question 360

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An otherwise healthy 50-year-old patient reports rectal fullness and pain while sitting. On examination, the rectal mucosa is smooth; however, you can palpate a large firm mass that appears extraluminal and extends to the tip of your examining finger. Cross-sectional imaging reveals a large heterogeneous presacral mass that measures 7 cm x 10 cm. The best next step in management is

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