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Infection with human immunodeficiency virus (HIV) is associated with the development of a wide variety of malignancies. The most common cancer associated with HIV infection is Kaposi's sarcoma. Other types of malignancies associated with HIV infection include cancers of the lymphatic system, bone marrow, mouth, testes, and anus. A case is described of a 43-year-old man with HIV infection who developed small cell cancer of the rectum. The patient, an anoreceptive homosexual male, was admitted with a seven-week history of rectal bleeding, constipation, thin stools, and tenesmus, or spasms of the anal sphincter. He was found to have a painless, rectal mass, and biopsy of the rectal mass indicated it was small cell cancer. The patient was treated with several anticancer agents and radiation therapy, but died from complications of the tumor eight months after his initial diagnosis and therapy. These results and findings from other studies suggest that sexual practice and viral species other than HIV may play a role in the development of anorectal cancer in patients with acquired immunodeficiency syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)